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在默克尔细胞癌中与免疫检查点抑制剂相关的不自主性:一个病例报告

Nidhi Kuchimanchi¹, Sai Gajula¹, Elizabeth M Gaughan¹

¹School of Medicine, University of Virginia, Charlottesville, Virginia, USA.

Cancer reports (Hoboken, N.J.)

|July 7, 2025

概括

免疫检查点抑制剂 (ICI) 可能导致罕见的自主神经系统副作用 (dysautonomia). 及时诊断和用静脉注射免疫球蛋白 (IVIG) 治疗改善了默克尔细胞癌患者的症状.

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:

免疫检查点抑制剂 (ICI) 是一种通过调节T细胞激活来向癌症的疗法.
免疫相关不良事件 (irAEs) 是已知的ICI毒性,影响各种系统.
与ICI相关的dysautonomia是一种罕见但显著的irAE,管理不确定.

研究的目的:

在患有默克尔细胞癌的患者中报告ICI相关的dysautonomia病例.
描述这种罕见毒性的临床表现,管理和结果.
审查关于ICI诱导的自主症的现有文献.

主要方法:

一个57岁的男性患者的病例报告,他接受了新辅助剂nivolumab的治疗.
详细描述患者的ICI相关的dysautonomia症状 (静止性低血压,尿液保留,听力损失,双眼视) 和并发性肝炎.
在ICI诱导的dysautonomia上进行文献综述.

主要成果:

患者出现了与ICI相关的显著的异常性和肝炎.
静脉注射免疫球蛋白 (IVIG) 的治疗导致dysautonomia显著的临床改善.
由ICI引起的失自症呈现出多种表现.

结论:

与ICI相关的dysautonomia是一种罕见且具有挑战性的irAE.
早期发现和及时治疗,如IVIG,对于患者的康复至关重要.
了解iRAE的广泛范围对于管理ICI治疗的患者至关重要.

关键词:

案例报告案例报告两种自主性两个自主性免疫检查点抑制剂免疫检查点抑制剂与免疫相关的不良事件这就是尼沃卢马布 (nivolumab).

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