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免疫检查点抑制剂在恶性多叶膜间皮瘤中使用后的单核尿路综合炎

Antonio Farina^1,2, Manon Escalere³, Matthias Dion¹

¹Centre de Référence Français des Syndromes Neurologiques Paranéoplasiques et des Encéphalites Auto-immunes, Hospices Civils de Lyon, Hôpital Neurologique, Bron, France.

Frontiers in neurology

|February 9, 2024

概括

单单尿道多重性炎是免疫检查点抑制剂的罕见不良事件,通常与血管性神经病变有关. 这一病例系列强调了三名患有这种严重但可治疗的疾病的间皮瘤患者.

科学领域:

神经学神经学
在瘤学瘤学.
免疫学免疫学免疫学

背景情况:

单单尿道多重性炎通常与血管性神经病变有关.
据报道,免疫检查点抑制剂 (ICI) 很少引起多重单单尿道炎.

研究的目的:

报告和描述单单尿道多重性炎作为ICI治疗中质瘤患者的罕见不良事件.
提高临床医生对这种严重但可治疗的ICI诱导的神经并发症的认识.

主要方法:

从法国临床网络 (2015-2022) 中确定了三名患有间皮瘤和单性尿道多重性炎的患者病例系列.
患者接受了尼沃卢马布加上伊皮利穆马布治疗腹间皮瘤.
神经学评估包括神经传导研究和外围神经活检;不良事件分类使用CTCAE.

主要成果:

三名男性患者 (平均年龄86岁) 患有多叶层层瘤,在尼沃卢马布/伊皮利穆马布治疗后出现严重的 (CTCAE 3级) 单单尿道复合炎.
神经传导研究证实了单单尿道多重性炎;活检显示了血管炎或IgA沉积.
治疗ICI戒断,皮质类固醇,在一个案例中,rituximab/cyclophosphamide,导致症状改善或回归.

结论:

多重单核性单核炎是一种非常罕见但严重的不良事件,与梅索瘤患者的ICI相关.
早期识别和适当的管理,包括免疫抑制,对于有利的结果至关重要.
临床医生应考虑ICI在癌症患者新发的神经病变的差异诊断.

关键词:

免疫检查点抑制剂免疫检查点抑制剂一个单单尿道多重性炎.在 n-irAEs 中.神经血管炎是一种神经血管炎.神经系统免疫相关的不良事件.神经学毒性神经学毒性血管性神经病变是一种神经病变.

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