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免疫检查点抑制剂相关肌炎中的食道功能障碍:一个病例报告
Yoya Ono1, Kenjiro Kunieda1,2, Tomohisa Ohno3
1Department of Neurology, Gifu University Graduate School of Medicine, Japan.
Internal medicine (Tokyo, Japan)
|December 25, 2024
概括
免疫检查点抑制剂 (ICI) 治疗可以导致肌肉炎,导致肌肉衰弱. 这项研究表明,ICI相关的肌肉炎也可能导致未被识别的食道功能障碍,影响吞.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 胃肠病学 胃肠病学
背景情况:
- 免疫检查点抑制剂 (ICI),如 pembrolizumab,用于治疗各种癌症.
- ICI治疗可以诱导与免疫相关的不良事件,包括肌肉炎,其特征是肌肉炎症和肌肉衰弱.
- 食道功能障碍是已知的异常性炎症性肌肉病症的并发症,但其与ICI相关肌肉炎的关联性不太清楚.
研究的目的:
- 在患有免疫检查点抑制剂 (ICI) 相关肌肉炎的患者中调查潜在的食道功能障碍.
- 为了评估吞功能,尽管缺少消化不良症状.
主要方法:
- 一名接受 pembrolizumab 治疗的乳腺癌患者患上了 ICI 相关的肌肉炎.
- 进行了视频光镜吞研究 (VFSS),以评估吞.
- 使用高分辨率测量仪 (HRM) 来评估食道运动性和关功能.
主要成果:
- VFSS揭示了低食道中的残留物,表明清除受损.
- HRM 显示上食道关节开口受损,食道周围静止缺失.
- 这些食道异常在免疫治疗后部分改善.
结论:
- 食道功能障碍,包括运动和关功能受损,可能发生在ICI相关肌肉炎的患者中.
- 这表明食道干扰可能是ICI诱导肌肉病的未被认可的并发症.
- 需要进一步的研究来阐明ICI治疗患者食道功能障碍的患病率和临床意义.
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