由PD-1抑制剂引起的甲状腺炎和ACTH缺乏症
Nayab Shah1, David Prentice2, Chandrin Jayasundera3
1St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia dr.nayab.shah@gmail.com.
BMJ case reports
|February 25, 2025
概括
针对癌症的编程细胞死亡1 (PD-1) 抑制剂疗法可能会导致低血清炎,导致疲劳和恶心. 早期识别和皮质醇替代对于控制这种副作用至关重要.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 布罗利祖马布是一种PD-1抑制剂,用于非小细胞肺癌.
- 癌症治疗可以导致与免疫相关的不良事件.
- 低血脂炎是PD-1抑制剂的已知但经常被忽视的副作用.
研究的目的:
- 为了突出PD-1抑制剂诱导的低体质炎的潜力.
- 强调识别非特异性症状的重要性.
- 倡导及时诊断和管理下体炎.
主要方法:
- 一名患者的病例报告,该患者在治疗非小细胞肺癌时接受了 pembrolizumab.
- 临床观察症状,包括疲劳,恶心和运动能力下降.
- 诊断证实了低体质炎的发生.
- 对皮质醇替代治疗的治疗反应的评估.
主要成果:
- 患者呈现出逐渐疲劳,难以治疗的恶心和运动能力下降.
- 确诊了PD-1抑制剂诱导的低血压炎的诊断.
- 皮质醇替代导致了显著的症状改善.
结论:
- 低血清炎可以表现为恶心和疲劳等非特异性症状.
- 由于对瘤学以外的PD-1/PD-L1抑制剂疗法不熟悉,诊断延迟可能发生.
- 医生应该考虑这些症状的患者的低血糖炎,即使没有低血糖或低血糖.
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