免疫检查点抑制剂（Immune checkpoint inhibitors，ICIs）是一类广泛使用的癌症免疫疗法。自2000年代引入以来，这些药物已经改善了癌症的治疗效果。尼伐替尔回诺（Nivolumab）是一种ICIs，可用于尚未接受过治疗的肾细胞癌。免疫相关不良事件（immune-related adverse events，irAEs）是与过度活化的免疫系统相关的免疫疗法不良事件的一种类型。我们报告了一例69岁的白种人男性，患有Ⅳ期肾细胞癌，他开始服用尼伐替尔回诺后的五个月内出现早晨关节僵硬至少三小时，关节肿胀、热感和红斑等症状，被肿瘤学家转诊至乡村社区风湿病门诊。患者被诊断为免疫相关的ICIs继发阴性风湿性关节炎，并需要较高剂量的强的松（每天最高40毫克）联合甲氨蝶呤以达到缓解效果。随着ICIs的广泛应用，乡村社区的风湿学免疫相关不良事件可能会增加。临床医生在照顾癌症患者时需要意识到ICIs的不良反应。版权所有 © 2023，De Camps Martinez等。

Immune checkpoint inhibitors (ICIs) are a widely used class of cancer immunotherapy. Those drugs have improved the treatment of cancer since its introduction in the 2000s. Nivolumab is an ICI that can be used for previously untreated renal cell carcinoma. Immune-related adverse events (irAEs) are a type of adverse event of immunotherapy that is associated with an overreactive immune system. We report a case of a 69-year-old Caucasian man with stage IV renal cell carcinoma who presented to a rural community-based rheumatology clinic referred by his oncologist, after starting to develop morning stiffness for at least three hours, joint swelling, warmth, and erythema five months after starting immunotherapy with nivolumab. The patient was diagnosed with seronegative rheumatoid arthritis secondary to ICIs and required a higher dose of prednisone (up to 40 mg per day) with methotrexate to achieve remission. With the widespread availability of ICIs, rheumatologic irAEs can be encountered in a rural community-based practice. Practicing physicians taking care of cancer patients need to be aware of the adverse effect of ICIs.Copyright © 2023, De Camps Martinez et al.