过敏的辐射肺炎后严重的irAE
Yang Chou1,2, Wei-Kai Chuang3,4
1Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan.
Diagnostics (Basel, Switzerland)
|April 26, 2024
概括
一名患有复发的三阴性乳腺癌的患者在治疗期间患上了肺囊炎肺炎. 及时诊断和TMP-SMX和类固醇治疗导致康复,突出了免疫功能低下的癌症患者的机会性感染.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 三重阴性乳腺癌 (TNBC) 复发带来了重大治疗挑战.
- 免疫检查点抑制剂 (ICI) 如 pembrolizumab 在TNBC中使用,但可能导致与免疫相关的不良事件.
- 晚期癌症患者和接受免疫抑制疗法的患者有机会性感染的风险.
研究的目的:
- 在接受ICI和放射治疗的TNBC复发患者中报告Pneumocystis jiroveci肺炎 (PJP) 的病例.
- 强调在免疫功能低下的癌症患者出现呼吸道症状时考虑机会性感染的重要性.
- 为了强调PJP在这个复杂的临床场景中的成功管理.
主要方法:
- 一个54岁妇女的病例报告,患有复发性TNBC和骨转移.
- 治疗包括pembrolizumab,taxane和放射治疗.
- 通过支气管洗PCR证实了PJP的诊断.
- 治疗包括抗生素 (TMP-SMX) 和葡萄糖皮质类药物.
主要成果:
- 患者经历了庞布罗利祖马布的严重皮肤毒性,导致治疗中止.
- 胸骨质量的放射治疗因呼吸不良和发烧而复杂,暗示PJP.
- 在支气管洗中发现了Pneumocystis jiroveci.
- 呼吸系统症状通过TMP-SMX和甲基prednisolone得到缓解.
结论:
- 机会性感染,如PJP,可以发生在接受免疫治疗和放射治疗的晚期癌症患者中.
- 早期识别和适当治疗PJP对于患者的康复至关重要.
- 对复杂病例来说,涉及瘤学,传染病和肺病学的多学科管理是必不可少的.
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