免疫检查点抑制剂（ICIs）的引入革新了癌症治疗标准，并显著提高了患者预后。然而，这些突破性疗法的运用导致了各种类型的不良事件的观察和报告，通常称为免疫相关不良事件（irAEs）。在本文中，我们呈现了4例使用ICIs引发的罕见毒副作用的患者。第一位患者是一名59岁的女性，被诊断为4期肺腺癌。她接受了免疫疗法（帕姆单抗）联合化疗，并随后出现了自主神经病变（AN）。接下来的两位患者也接受了化疗免疫疗法（帕姆单抗），他们都是63岁的男性，患有4期肺腺癌。其中一人出现了掌跖角化过度症，而另一人出现了Reiter综合征（尿道炎、结膜炎和关节炎）。第4位患者是一名80岁的男性，患有4期肺鳞癌，接受了化疗免疫疗法（帕姆单抗），并发生了重症肌无力。

The introduction of immune checkpoint inhibitors (ICIs) has revolutionized cancer treatment standards and significantly enhanced patient prognoses. However, the utilization of these groundbreaking therapies has led to the observation and reporting of various types of adverse events, commonly known as immune-related adverse events (irAEs). In the following article, we present four patients who encountered uncommon toxicities induced by ICIs. The first patient was a 59-year-old female diagnosed with stage 4 lung adenocarcinoma. She received immunotherapy (pembrolizumab) together with chemotherapy and subsequently developed autonomic neuropathy (AN). The next two patients also received chemo-immunotherapy (pembrolizumab) and were both 63-year-old males with stage 4 lung adenocarcinoma. One of the two experienced palmoplantar keratoderma, while the other presented with Reiter's syndrome (urethritis, conjunctivitis and arthritis). The 4th patient, an 80-year-old male with stage 4 squamous cell carcinoma of the lung, received chemo-immunotherapy (pembrolizumab) and developed myasthenia gravis.