标记性低脂血症在免疫检查点抑制剂诱导的获得性全般化脂质变异中预先发生明显的脂肪损失
Maheswaran Dhanasekaran1, Rashi Sandooja1, Alexandra S Higgins2
1Department of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, MN, USA.
JCEM case reports
|November 1, 2023
概括
免疫检查点抑制剂可能会导致脂质,这是一个罕见的疾病,涉及脂肪损失和代谢问题. 这一案例突出了诸如口腔脂肪损失和低勒素等早期症状,这在一般化脂质变之前发生.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 彻底改变了转移性癌症的治疗方法.
- ICI治疗与各种内分泌病症有关.
- 脂质缩是一种较少被认可的,可能与自身免疫相关的ICI的不良影响.
研究的目的:
- 为了呈现ICI治疗次要的获得性脂质变病例.
- 描述临床表现和代谢并发症.
- 阐明涉及亚临床泛炎的潜在机制.
主要方法:
- 一名66岁的妇女因转移性肺腺癌而接受 pembrolizumab 治疗的情况报告.
- 临床评估包括代谢参数 (高血糖,高脂血症) 和体检 (口腔脂肪损失).
- 实验室检测 (血清瘦素) 和全身FDG-PET扫描以评估脂肪组织炎症.
主要成果:
- 患者患有高血糖症,高脂血症和肝硬化症,而不是自身免疫性糖尿病.
- 最初的发现是孤立的口腔脂肪损失和无法检测到的瘦素水平.
- FDG-PET扫描显示了扩散的皮下炎症,随后是渐进的泛化脂质变.
结论:
- 获得性脂质营养不良是一种ICI治疗的潜在不良影响.
- 亚临床泛肠炎可能先于明显的脂肪损失和代谢功能障碍.
- 低血和代谢异常是ICI诱导的脂肪组织功能障碍的特征.
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