一种由免疫检查点抑制剂引起的胃炎病例,该药物被用infliximab治疗
Shizu Itsukage1, Noriko Kume1, Aki Tajima1
1Department of Dermatology, Kansai Medical University Hospital, 2-5-1 Shinmachi, Hirakata City, Osaka Japan.
International cancer conference journal
|October 14, 2024
概括
免疫检查点抑制剂 (ICI) 可以导致罕见的免疫相关胃炎. 恩弗利克西马布有效地治疗了因尼沃卢马布引起的耐火性吐和厌食症的患者,突出了针对这种ICI副作用的治疗选择.
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:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 免疫相关不良事件 (irAEs) 是已知的ICI并发症,影响各种器官.
- 胃炎是一种与ICI治疗相关的罕见但显著的irAE.
研究的目的:
- 报告一种罕见的免疫治疗相关的胃炎病例.
- 突出耐火症状的临床表现和管理.
- 强调识别和治疗ICI引起的胃炎的重要性.
主要方法:
- 一个患有皮肤恶性黑色素瘤的患者用尼沃卢马布治疗的病例介绍.
- 症状描述,包括耐火性吐和厌食症.
- 对治疗策略的审查,包括皮质类固醇和infliximab.
主要成果:
- 患者在nivolumab治疗后出现了严重的胃炎与耐火性吐和厌食症.
- 最初使用口服皮质类固醇治疗的疗效有限.
- 随着INFLIXIMAB治疗,患者的症状得到了显著改善.
结论:
- 免疫治疗相关的胃炎是一种与ICI相关的新兴的irAE.
- 因弗利克西马布可以作为耐火性ICI诱导胃炎的有效治疗方法.
- 在接受ICI的患者中,临床医生必须保持对像胃炎这样的irAEs的高怀疑指数.
相关概念视频
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
117
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
117
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
143
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
143
Inflammatory Bowel Disease IV: Pharmacological Management
118
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
118
Gastritis III: Clinical Manifestations and Management
170
The clinical manifestations of gastritis can vary depending on the cause and type of gastritis, but some common symptoms may include the following.
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
170
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
97
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
97
Drugs for Treatment of Ulcerative Colitis in IBD
126
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
126


