经由免疫检查点抑制剂阻断PD-1后复发性多重合体炎
Tomoyuki Mutoh1, Sonoko Chikamatsu2, Takatsuna Sasaki3
1Department of Rheumatology, Osaki Citizen Hospital, Osaki, Japan.
JMA journal
|November 9, 2023
概括
免疫检查点抑制剂 (ICI) 可以引起罕见的类风湿性副作用,如复发性多重合体炎 (RP). 这个病例显示了布罗利祖马布诱导的RP与耳朵炎症,在停止药物后消失了.
科学领域:
- 类风湿病学 类风湿病学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI),如 pembrolizumab 在癌症治疗中至关重要.
- 免疫相关不良事件 (irAEs) 是已知的并发症,但复发性多重体炎 (RP) 很少报告.
- 了解RP作为irAE对于患者管理至关重要.
研究的目的:
- 报告布罗利祖马布诱导的复发性多合体炎 (RP) 的第一个病例,呈现出孤立的耳部病变.
- 调查布罗利祖马布停用和重新挑战后RP的解决方案.
- 审查PD-1抑制诱导的RP的文献.
主要方法:
- 一个患有下唇癌症的病人用 pembrolizumab 接受治疗的病例报告.
- 临床评估,实验室测试 (C-反应蛋白),成像 (CT,18F-FDG-PET/CT) 和活检用于诊断.
- 关于与PD-1抑制剂相关的RP的回顾性文献综述.
主要成果:
- 患者在开始服用 pembrolizumab 后出现耳部胀和疼痛,被诊断为 RP.
- 症状在布罗利祖马布停止后自发消失,并在重新服用后复发.
- 病人最终死于癌症的进展,尽管治疗修改.
结论:
- 复发性多重合体炎在接受抗PD-1治疗的患者中可以表现为类风湿性irAE.
- 布罗利祖马布诱导的RP可能异常呈现,与隔离的耳膜干扰有关,并且在没有免疫抑制的情况下消失.
- 意识到RP作为潜在的irAE对于癌症患者的及时诊断和管理至关重要.
相关概念视频
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
2.8K
Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation
Chronic Inflammation
2.8K
Rheumatic Heart Disease I: Introduction
14
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
14
Peripheral Artery Disease I: Introduction
9
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs but also impacts other areas, such as the arms, thereby impairing overall circulation and organ function.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty deposits inside the arterial...
9
Pericarditis I: Introduction
10
Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
10
Pericarditis III: Medical Management
13
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
13


