免疫检查点抑制剂诱导了周围神经系统的副作用
Thomas Hundsberger1,2, Bettina Schreiner3, Patrick Roth3
1Department of Neurology.
Current opinion in neurology
|August 28, 2023
概括
免疫检查点抑制剂诱导的神经副作用 (irNAEs) 模仿自身免疫性疾病,冒着误诊的风险. 早期检测和治疗对于预防永久性损伤和死亡至关重要,特别是在重叠综合征中.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以引起与其他自身免疫疾病相似的神经系统副作用 (irNAE).
- 神经系统症状,如虚弱和疲劳可能是非特异性的,导致延迟诊断和治疗.
- 在irNAE中自抗体的诊断作用是复杂的,因为在某些情况下,已经存在的抗体和缺乏发展.
研究的目的:
- 审查目前关于诊断和治疗irNAEs的知识,重点关注神经肌肉并发症.
- 突出IRNAE诊断的挑战,包括非特异性症状和自身抗体争议.
- 讨论肌/肌炎/肌心炎重叠综合征的具体风险和管理.
主要方法:
- 关于irNAEs的最新研究的文献综述.
- 对irNAEs的诊断标准和治疗方法的分析.
- 专注于神经肌肉表现和相关的自身免疫综合征.
主要成果:
- irNAEs经常模仿零星的神经肌肉自身免疫性疾病和副瘤综合征.
- 一种新型的死性肌肉炎 (irMyositis) 呈现出面部软弱和亡,模仿肌痛严重症.
- 肌/肌炎/心肌炎重叠综合征与高死亡率有关.
结论:
- 早期怀疑和诊断irNAEs对于预防神经系统后果至关重要.
- 对irNAEs的治疗通常遵循用于零星自身免疫性疾病的方法.
- 肌/肌炎/心肌炎重叠综合征需要特别注意,因为其死亡风险很高.
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