布罗利祖马布诱导的与免疫相关的硬化性胆管炎
Yuchen Li1, Lori Stewart2, Shangguo Tang3
1Medical Oncology, Juravinski Cancer Centre, Hamilton, Ontario, Canada.
BMJ case reports
|November 1, 2023
概括
免疫相关的硬化胆管炎 (irSC) 是癌症免疫疗法的罕见副作用. 这项案例研究表明,当类固醇失败时,ursodeoxycholic acid (UDCA) 可能有效治疗irSC.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 癌症免疫疗法,包括检查点抑制剂,如 pembrolizumab,是一个不断增长的治疗方式.
- 免疫相关不良事件 (irAEs) 是免疫治疗的常见并发症.
- 免疫相关的硬化胆管炎 (irSC) 是一种罕见的肝脏irAE,治疗策略不清楚.
研究的目的:
- 报告一个与免疫相关的硬化性胆道炎 (irSC) 的病例,该病例是对转移性黑色素瘤的 pembrolizumab 治疗次要的.
- 为了评估ursodeoxycholic acid (UDCA) 在对传统类固醇治疗无反应的irSC的管理中的有效性.
主要方法:
- 一个患有转移性黑色素瘤的病人用 pembrolizumab 接受治疗的病例报告.
- 描述irAEs,包括irSC,及其管理.
- 治疗结果与普得尼松和随后的UDCA治疗的比较.
主要成果:
- 尽管患者初步接受了高剂量普得尼松的治疗,但患者患上了IRSC.
- 随后给予UDCA导致irSC症状完全消失.
- 在UDCA治疗后观察到肝功能测试和放射性发现的正常化.
结论:
- 免疫相关的硬化性胆管炎 (irSC) 可能对标准的皮质类固醇治疗没有反应.
- Ursodeoxycholic 酸 (UDCA) 是一种潜在的替代性治疗选择,可以治疗 irSC.
- 临床医生应考虑UDCA在接受免疫治疗的患者中管理irSC.
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