尼沃卢马布诱导的免疫介导性大肠炎,在内镜和组织学上模仿性大肠炎
Daniel Muíño Domínguez1, Fernando Fernández Cadenas2, María Helena González Sánchez3
1Aparato Digestivo, Hospital Universitario Central de Asturias, España.
像Nivolumab这样的编程细胞死亡蛋白1 (PD-1) 抑制剂治疗癌症,但可以引起免疫媒介性结肠炎. 这一案例突显了尼沃卢马布诱导的结肠炎模仿性结肠炎,强调需要仔细监测.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 免疫疗法,特别是编程细胞死亡蛋白1 (PD-1) 抑制剂,通过利用免疫系统改变了癌症治疗.
- 尼沃卢马布是一种抗PD-1药物,增强了抗瘤免疫反应,但可以引起免疫媒介的不良事件.
- 免疫媒介性结肠炎是免疫治疗的显著胃肠道副作用,与抗CTLA4药物比抗PD-1药物更为常见.
研究的目的:
- 在患有转移性清晰细胞癌的患者中报告由Nivolumab诱导的免疫媒介性结肠炎病例.
- 为了说明Nivolumab诱导的大肠炎和性大肠炎之间的内镜和组织学相似之处.
主要方法:
- 一个62岁男性的病例研究,他接受了因转移性清晰细胞癌而接受Nivolumab治疗.
- 评估了临床表现,结肠镜检查结果和结肠活检的组织病理学分析.
主要成果:
- 患者在接受Nivolumab治疗后出现腹痛和腹,与大肠炎一致.
- 结肠镜检查显示了持续的粘膜炎症,侵蚀和排泄物. 活检显示有活性结肠炎,隐秘,以及焦点隐藏炎.
- 这些发现模仿了性结肠炎在内镜和组织学上.
结论:
- 尼沃卢马布可以诱导免疫媒介性结肠炎,这是一个显著的胃肠道不良事件.
- 尼沃卢马布诱导的大肠炎的内镜和组织学特征可能与性大肠炎非常相似,需要仔细的差异诊断.
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