A case of ICIs-associated arthritis caused by Toripalimab initially presenting as oedema in both lower limbs.
Jie-Ling Zhang, Hao Yang, Zhi-Li Zhou et al.
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Case in brief
A patient with advanced colon cancer developed swelling in both lower limbs after treatment with the immune checkpoint inhibitor toripalimab. The presentation was ultimately attributed to immune checkpoint inhibitor-associated arthritis, a toxicity described as nonspecific and lacking diagnostic criteria. The arthritis improved after steroids were administered, while the tumour remained well controlled.
What made this case unusual
The arthritis initially presented as bilateral lower-limb oedema, a presentation that may obscure its recognition as an immune-related adverse event.
Diagnostic / clinical pearl
In a patient receiving toripalimab, bilateral lower-limb oedema may be the presenting feature of immune checkpoint inhibitor-associated arthritis; consider this toxicity despite its nonspecific presentation.