免疫检查点抑制剂诱导了脑膜炎:一个病例系列
Laurence Gascon1, Sarah Benyo1, Rebecca C Nelson1
1Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, U.S.A.
The Laryngoscope
|May 14, 2024
概括
这一病例系列突出显示了呼吸道上腺炎,这是一种罕见的呼吸道并发症,发生在接受免疫检查点抑制剂 (ICI) 治疗癌症的患者中. 早期识别和管理对于免疫治疗的潜在危及生命的呼吸系统副作用至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 与ICI相关的不良事件多样化,但呼吸道并发症很少见.
- 膜炎是一种可能危及生命的上呼吸道炎症.
研究的目的:
- 在接受免疫治疗的患者中报告一系列两例超膜炎.
- 审查有关与免疫检查点抑制剂相关的呼吸道并发症的文献.
主要方法:
- 两名患有免疫治疗相关的脑膜炎的患者的病例系列.
- 对与免疫检查点抑制剂相关的呼吸道并发症现有文献的审查.
主要成果:
- 两名患者在免疫疗法 (尼沃卢马布/雷拉利马布和布洛利祖马布) 期间出现了显著的膜炎.
- 症状包括发声障碍,消化障碍和喉不适,由喉腔镜检查证实,显示呼吸道和胀.
- 两位患者都接受了全身类固醇,抗生素和/或抗真菌药物的治疗,并有所改善.
- 由于并发症的严重程度,一个患者的免疫疗法被推迟了.
- 在文献搜索中发现了与ICI相关的三个额外的气管炎病例.
结论:
- 这是第一个描述免疫检查点抑制剂治疗的患者中膜炎的病例系列.
- 耳膜炎是免疫疗法的新出现的,可能是严重的呼吸系统副作用.
- 这些发现有助于越来越多地了解ICI对呼吸道的影响.
相关概念视频
Myasthenia Gravis: Overview and Treatment
Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which leads...
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which leads...
Tonsillitis I: Introduction
Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
Etiology
Three primary contributing factors have been identified.
Tonsillitis II: Management
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
Barrett Esophagus-II: Clinical Manifestations and Management
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Myocarditis III: Medical Management
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...


