与抗PD1疗法相关的远端管酸性症:一个病例报告
Xuejia Qiu1, Bingnan Ren1, Lingzhi Fang1
1Department of Pharmacy, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China.
Experimental and therapeutic medicine
|July 17, 2023
概括
这项研究报告了第一个患有远端管酸症 (RTA) 的病例,这是一个罕见的副作用,患者接受编程细胞死亡蛋白1 (PD-1) 抑制剂sintilimab. 终止治疗和支持性护理导致康复.
科学领域:
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI),如编程细胞死亡蛋白1 (PD-1) 抑制剂,越来越多地用于癌症治疗.
- 对ICI的不良反应可能包括与免疫相关的不良事件 (irAEs),管化 (RTA) 是一种罕见的并发症.
- 辛提利马布是一种ICI,其向PD-1通路.
研究的目的:
- 报告第一个已知的离远RTA病例,该病例是辛提利马布治疗的次要病例.
- 为了突出与PD-1抑制剂治疗相关的罕见但显著的不良事件.
主要方法:
- 一份病例报告显示,一名62岁的男性患者患有转移性心脏癌症,接受了sintilimab治疗.
- 临床观察新陈代谢异常,包括高血酸性化和低血症,在施用sintilimab后.
- 诊断评估包括尿液和血液测试,以确定酸性疾病的原因.
- 干预包括停止辛蒂利马布和化疗,并启动二碳酸和酸.
主要成果:
- 患者在第四剂 sintilimab后发生了代谢性高血性酸性结核与低血症.
- 免疫疗法诱导的远端RTA是基于临床和实验室发现来诊断的.
- 用二碳酸和酸治疗导致了足够的临床反应,解决了酸性疾病.
结论:
- 这一病例代表了与sintilimab (抗PD-1疗法) 相关的远端RTA的第一个记录实例.
- 远端RTA是sintilimab的一种潜在的,尽管很少见的副作用,临床医生应该知道.
- 及时识别和管理,包括戒药和支持性治疗,对于患者的康复至关重要.
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