一个罕见的免疫相关不良事件,局限于小肠的罕见病例
Ryo Morikawa1, Ryosuke Kanaya1, Hiromichi Shimizu1
1Department of Gastroenterology and Hepatology Institute of Science Tokyo Japan.
DEN open
|September 10, 2025
概括
免疫相关的不良事件 (irAEs) 可以导致肠炎,小肠炎症. 这一案例凸显了检查小肠是否有irAE肠炎的重要性,即使结肠镜检查结果正常,以确保及时诊断和治疗.
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:
- 内肠炎是免疫相关不良事件 (irAEs) 的常见胃肠道表现.
- 很少有人报告irAE肠炎,特别是局部小肠炎症.
- 免疫检查点抑制剂 (ICI),如阿特佐利祖马布,可以触发irAEs.
研究的目的:
- 报告一种罕见的IRAE肠炎病例,局限于小肠.
- 强调IRAE肠炎的诊断挑战和临床意义.
- 强调在ICI治疗期间患有胃肠道症状的患者小肠评估的重要性.
主要方法:
- 一名74岁的男子因肺腺癌而接受阿特佐利祖马布治疗的病例报告.
- 诊断工作包括计算机断层扫描和肠直肠镜检查.
- 治疗涉及普雷尼索隆,症状和内镜随访.
主要成果:
- 患者出现了腹,腹痛,并难以口服.
- 肠直肠镜检查显示小肠中的活跃炎症,而不是结肠.
- 普雷迪尼索隆治疗导致症状迅速改善,并在随访内镜检查时减少炎症.
结论:
- irAE肠炎是一种罕见但严重的ICI的胃肠毒性.
- 诊断存在挑战,因为炎症可能局限于小肠.
- 对于在ICI治疗期间出现胃肠道症状的患者来说,即使在正常结肠镜检查中,彻底检查小肠道是至关重要的.
相关概念视频
Inflammatory Bowel Disease II: Crohn's Disease
961
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
961
Inflammatory Bowel Disease I: Ulcerative Colitis
904
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
904
Drugs for Treatment of Ulcerative Colitis in IBD
463
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
463
Chronic Bowel Disorders: Introduction
748
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
748
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
644
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
644
Histology of the Small Intestine
3.5K
The small intestine exhibits a unique histological structure that significantly enhances its function in digestion and nutrient absorption. These structures include circular folds, villi, and various specialized cells that collectively facilitate the digestion of food.
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...
3.5K


