Loading
Life sciences · Journal article
Frontiers in Immunology · October 21, 2026
No summary has been generated for this record yet. What follows is drawn from its source metadata only.
Journal article.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This record has not been graded across any dimension yet. Treat the label above as provisional and read the source.
What is missing. This record has no bottom line, key findings, reported figures, evidence dimensions. That is a gap in the analysis, not a judgement about the study.
Immune checkpoint inhibitor (ICI) have substantially extended survival in patients with extensive-stage small-cell lung cancer (ES-SCLC), yet they also carry the risk of life-threatening immune-related adverse events (irAEs). Clinical experience in managing multi-organ irAEs (MO-irAEs) complicated by respiratory failure and subsequent severe pneumonia remains exceedingly scarce. Here we report a 71-year-old patient with ES-SCLC (stage IVb, with brain and splenic metastases) who, after four cycles of serplulimab plus chemotherapy, sequentially developed myocarditis, myositis, and hepatic injury. Following premature tapering of glucocorticoid therapy, the patient experienced a recurrence of ICI-related toxicity, manifesting as hypophysitis, primary hypothyroidism, and adrenal insufficiency-alongside respiratory failure-and later acquired multidrug-resistant infection during the treatment course. Through individualized moderate-dose glucocorticoids, comprehensive hormone replacement, and pathogen-directed antimicrobial therapy with eravacycline and ceftazidime-avibactam guided by metagenomic next-generation sequencing (mNGS), the infection was ultimately brought under control and multi-organ dysfunction reversed. This case underscores several key points: (1) serplulimab can precipitate multi-endocrine gland insufficiency, and severe hypothyroidism may be one of the factors contributing to the respiratory failure, mandating a high index of clinical suspicion; (2) glucocorticoid regimens should adhere to adequate initial dosing, sufficient duration, and slow tapering-abrupt discontinuation risks triggering recurrence of ICI-related toxicity; and (3) rapid, precise lower-respiratory-tract pathogen identification coupled with targeted antimicrobial therapy offers particular value in managing severe pneumonia caused by drug-resistant organisms.