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与免疫相关的不良事件相关的肠炎中严重的光线狭窄:一个病例报告
Akifumi Fukui1, Yusuke Okuyama2, Go Sawai1
1Department of Gastroenterology, Japanese Red Cross Society Kyoto Daiichi Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
免疫检查点抑制剂可以导致严重的肠炎和大肠炎. 早期识别和管理,包括布索尼德和内透镜气球扩张,对于患者的治疗结果和癌症控制至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 免疫检查点抑制剂 (ICI),如伊皮利马布和尼沃马布在癌症治疗中至关重要.
- 治疗ICI可能会导致与免疫相关的不良事件,特别是大肠炎和脑膜炎.
- 肠炎作为ICI诱导的不良事件很少被报告,特别是在日本,缺乏明确的发病率和特征.
研究的目的:
- 在ICI治疗后报告严重肠炎和结肠炎病例.
- 讨论ICI引起的肠炎的管理和结果.
- 强调仔细管理和监测ICI的重要性.
主要方法:
- 一个56岁的男性患者的案例研究,患有转移性肺瘤复发后细胞癌手术.
- 患者接受了ICI治疗,随后患上严重的结肠炎和肠炎.
- 管理涉及高剂量的普雷尼索隆,因弗利克西马布,亚总分泌切除术,结肠静脉切除术,口服布德索尼德和内透镜气球扩张.
主要成果:
- 患者患有严重的结肠炎和肠炎,导致结肠穿孔和手术干预.
- 术后肠炎与光线狭窄成功地通过口服布德索尼德和内镜气球扩张来管理.
- 患者在ICI开始后的3.5年内仍然活着,没有瘤复发,并保持口服摄入.
结论:
- ICI诱导的肠炎可能是严重的,需要迅速,积极的管理.
- 内镜气球扩张和布德索尼德为ICI诱导的肠炎与光线狭窄提供了有效的治疗方法.
- 由于潜在的严重胃肠道毒性,对ICI治疗,即使是单剂,必须进行警监测和仔细考虑.
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