免疫检查点抑制剂诱导的肌肉炎导致严重的死:一个病例报告
Nadine A Abdeljabbar1, Sabrina Genovese1, Mohamed B Haradwala1
1Department of Neurology, University of Missouri School of Medicine, Columbia, USA.
Cureus
|December 12, 2024
概括
布罗利祖马布可以引起免疫相关的不良事件 (irAEs),如尿路癌患者的,肌炎和心肌炎. 早期检测和使用类固醇和血交换的积极治疗对于管理这些潜在的严重并发症至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 神经学 神经学
背景情况:
- 布罗利祖马布是一种免疫检查点抑制剂,用于转移性尿路细胞癌.
- 虽然它是有效的,但它会带来与免疫相关的不良事件 (irAEs) 的风险.
- 从其他条件区分IRAEs可能是具有挑战性的.
研究的目的:
- 报告一个病例的严重的irAEs模仿肌痛性肌痛症在一个患者治疗 pembrolizumab.
- 要突出诊断难度在区分ICI诱导的肌肉炎从严重肌痛症.
- 强调警监测和积极治疗IRAEs的重要性.
主要方法:
- 一个77岁的女性患者的病例报告,患有尿路细胞癌,接受了 pembrolizumab 的治疗.
- 临床表现为严重的双边死,肌炎和心肌炎.
- 用高剂量类固醇和血交换进行诊断评估和治疗.
主要成果:
- 患者出现了,肌炎和心肌炎,最初被怀疑是3M综合征,但后来被确定为模仿肌痛严重症.
- 用高剂量类固醇和血交换成功治疗导致显著改善.
- 这个案例强调了ICI引起的并发症的诊断挑战.
结论:
- 在接受pembrolizumab的患者中,对像ptosis,myositis和心肌炎这样的irAEs进行警监测至关重要.
- 迅速和积极的治疗,包括类固醇和血交换,可以带来有利的结果.
- 这一案例强调了在免疫检查点抑制剂治疗的背景下,需要仔细区分肌肉炎和肌肉炎.
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