[免疫相关的史蒂文斯-约翰逊综合征/被编程死亡受体1抑制剂引起的有毒表皮溶解:一个病例报告]
1Department of Respiratory and Critical Care Medicine, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing 402760, China.
概括
一名患者在肺癌PD-1抑制剂治疗后出现严重的史蒂文斯-约翰逊综合征/有毒表皮解. 迅速治疗导致完全康复,突出了一个罕见但严重的不良事件.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 史蒂文斯-约翰逊综合征 (SJS) 和有毒表皮解体 (TEN) 是严重的,可能致命的疾病,影响皮肤和粘膜,通常是药物诱导的.
- 虽然通常与抗生素和NSAIDs有关,但以前没有报告来自编程死亡-1 (PD-1) 抑制剂的免疫相关SJS/TEN.
- 这一病例呈现了一个罕见的SJS/TEN实例,该病例是在肺癌患者接受PD-1抑制剂治疗后出现的.
研究的目的:
- 报告一个罕见的史蒂文斯-约翰逊综合征/有毒表皮解 (SJS/TEN) 病例,可能由编程死亡-1 (PD-1) 抑制剂治疗诱导.
- 描述SJS/TEN在接受组合免疫治疗的晚期肺癌患者的临床表现,治疗和结果.
主要方法:
- 一份病例报告详细介绍了一名患有晚期非小细胞肺癌 (NSCLC) 的患者,他接受了PD-1抑制剂 (Tirellizumab) 加上化疗治疗.
- 对SJS/TEN发育的临床观察,表皮脱落的程度,以及对综合管理的反应.
- 在瘤学中与PD-1抑制剂治疗相关的不良事件的综述.
主要成果:
- 一名患有KRAS G12S突变,PD-L1阴性,IV期NSCLC的患者在Tirellizumab,白蛋白-帕克利塔塞尔和碳白金的第三个周期后3周发展出广泛的SJS/TEN (表皮溶解>95%).
- 患者在永久停止免疫抑制剂并接受包括抗感染,激素治疗,营养支持和免疫球蛋白在内的综合性支持性护理后完全康复.
- 这代表了与使用PD-1抑制剂相关的SJS/TEN的首例报告.
结论:
- 编程死亡-1 (PD-1) 抑制剂,用于癌症免疫疗法,很少会导致严重的皮肤不良反应,如史蒂文斯-约翰逊综合征/有毒表皮解.
- 早期识别,迅速停止违规代理,以及积极的支持性护理对于管理SJS/TEN和改善患者结果至关重要.
- 这一案例强调了对新型癌症疗法的罕见但严重副作用的警的重要性.
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