布罗利祖马布诱导的甲状腺炎,下炎和上腺炎:三重内分泌功能障碍的病例
Silvia Rossi1, Francesca Silvetti1, Monia Bordoni1
1Endocrinology Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona 60126, Italy.
JCEM case reports
|November 5, 2024
概括
免疫检查点抑制剂,如pembrolizumab可以引起罕见的,顺序的自身免疫内分泌问题. 这一案例突出了三重毒性:甲状腺,垂体和上腺功能障碍,强调了对荷尔蒙功能障碍的仔细监测.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是革命性的癌症疗法.
- 自免疫内分泌不良事件是已知的ICI的副作用.
- 多次连续的内分泌毒性不常见.
研究的目的:
- 报告一例罕见的三次顺序内分泌病变,由布罗利祖马布诱导.
- 突出免疫疗法诱导的内分泌病变的可变和非典型表现.
- 强调ICI治疗期间对激素功能障碍的警监测的重要性.
主要方法:
- 一个39岁的男性患有转移性黑色素瘤的病例报告.
- 开始使用 pembrolizumab 的辅助疗法.
- 监测内分泌不良事件和荷尔蒙功能.
主要成果:
- 患者患有甲状腺毒性病,随后出现甲状腺功能低下症,需要服用莱沃西.
- 随后发生了中枢上腺功能不充分 (下皮炎),需要替代类固醇.
- 在停止服用潘布罗利祖马布后,垂体功能恢复了,但出现了原发性上腺功能不充分,需要fludrocortisone.
结论:
- 布罗利祖马布诱导了一种罕见的三重顺序性自身免疫内分泌病变.
- 免疫疗法诱导的内分泌异常可以呈现异常.
- 在ICI治疗期间,密切关注激素功能障碍的线索至关重要.
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