免疫检查点抑制剂诱导的肌炎/严重肌炎重叠
Caroline Gosser1, Anas Al Bawaliz2, Waled Bahaj2
1Internal Medicine, University of Louisville School of Medicine, Louisville, USA.
Cureus
|December 19, 2023
概括
免疫检查点抑制剂 (ICI) 可以导致自身免疫不良事件. 这一案例突出了pembrolizumab诱导的肌炎和严重肌炎,强调了迅速识别和干预的必要性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗,为各种恶性瘤提供长期疗效.
- 然而,ICI与免疫相关的不良事件 (irAEs) 相关,包括自身免疫性疾病.
- 由于非特异性症状和缺乏特定生物标志物,诊断irrAEs可能具有挑战性.
研究的目的:
- 为了呈现一个肌痛性骨髓灰质炎和肌肉炎的病例,该病例是对免疫检查点抑制剂pembrolizumab的次要病例.
- 强调识别和管理ICI诱导的IRE的重要性.
- 突出这些不良事件的诊断挑战和治疗策略.
主要方法:
- 一个病例报告是一名61岁的男性,患有非小细胞肺癌 (NSCLC),接受了 pembrolizumab 的治疗.
- 临床表现包括呼吸衰竭,最初被诊断为肌痛严重症危机.
- 进一步的评估表明pembrolizumab诱导的肌炎;治疗包括血合成,甲基prednisolone,和rituximab.
主要成果:
- 患者经历了显著改善后治疗与等离子体,甲基prednisolone,和rituximab.
- 该案例说明了一种复杂的自身免疫不良事件的呈现,这些不良事件可能是由pembrolizumab引起的.
- 成功的管理证明了联合治疗干预措施的有效性.
结论:
- 布罗利祖马布虽然有效治疗像NSCLC这样的癌症,但可以引发严重的自身免疫性疾病,如骨髓质疏松症和肌肉炎.
- 早期识别和迅速,积极治疗irrAEs对于患者的治疗结果至关重要.
- 临床医生和患者对潜在的ICI诱导的irrAEs的提高认识对于及时干预和管理至关重要.
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