伪膜性结肠炎:揭开一个罕见的罪祸首超越困难菌-一个病例报告
Manasa Ginjupalli1, Jayalekshmi Jayakumar1, Praneeth Bandaru2
1Department of Internal Medicine, The Brooklyn Hospital Centre, NY, USA.
概括
免疫疗法可以导致伪膜性结肠炎 (PMC),这是一个罕见的疾病. 这一案例突出了诊断挑战和成功的类固醇治疗在患有晚期胃癌的患者中这种不良影响.
科学领域:
- 胃肠病学 胃肠病学
- 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) 越来越多地用于晚期恶性瘤.
- 免疫疗法诱导的伪膜性结肠炎 (PMC) 是ICI的一种不常见但已知的不良影响.
- 由于其他大肠炎类型的重叠特征,PMC诊断可能具有挑战性.
研究的目的:
- 在患有胃腺癌的患者中呈现免疫疗法诱导的PMC病例.
- 为了突出与免疫治疗相关的大肠炎的非典型,扩散性结肠参与相关的诊断困难.
- 强调需要提高临床意识,并进一步研究免疫疗法诱导的大肠炎 (IMC).
主要方法:
- 一个68岁的男性患有胃腺癌,接受免疫疗法和化疗的病例报告.
- 排除常见病因,包括困难菌感染 (CDI).
- 诊断结肠镜与活检,揭示与PMC一致的发现.
- 用类固醇治疗进行治疗.
主要成果:
- 患者呈现出与PMC一致的症状,并排除了常见原因.
- 结肠镜检查显示了严重的粘膜堵塞和排泄物,表明PMC.
- 患者对类固醇治疗反应良好,逐渐改善.
- 这一案例说明了免疫疗法诱导的PMC的诊断挑战,特别是在扩散性结肠干扰的情况下.
结论:
- 免疫疗法诱导的PMC需要高度的临床怀疑,特别是在接受ICI的晚期癌症患者中.
- 临床,内镜和组织病理学发现与其他结肠炎形式的重叠使得及时诊断变得复杂.
- 进一步的研究对于完善免疫疗法诱导的大肠炎的诊断标准和管理策略至关重要.
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