Cytokine release syndrome

Background

• Cytokine release syndrome form of systemic inflammatory response syndrome from adverse effect of some monoclonal antibody drugs, as well as adoptive T-cell therapies

Clinical Features

• septic shock: hypotension, hypoxia, dyspnea, fever, tachycardia
• organ specific dysfunction: encephalopathy, coagulopathy, renal failure, CHF

Differential Diagnosis

• distinguish tumor lysis syndrome
• sepsis
• hemophagocytic lymphohistiocytosis

Evaluation

• cytopenias, elevated creatinine and liver enzymes, deranged coagulation parameters, high CRP

Management

• treat for sepsis
• consider Tocilizumab (IL-6 receptor antagonist)
• corticosteroids for severe cases

Disposition

• admit

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003181/