勃发作的心肌炎被布利祖马布诱导的肌炎揭露:延迟发作的双M综合征
Justin D Mark1, Ruben K A Tapia-Orihuela1, Alexander Llanos2
1Department of Internal Medicine, University of Miami Miller School of Medicine, Fort Lauderdale, Florida, USA.
JACC. Case reports
|November 3, 2025
概括
免疫检查点抑制剂 (ICI) 可以导致罕见的心肌炎和肌炎综合征. 这个病例显示了与ICI相关的双M综合征的延迟表现,强调了早期识别和多模式成像的必要性.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗.
- ICI可以诱导与免疫相关的不良事件,包括罕见的心肌炎和肌肉炎.
- 这些称为"双M综合征"的综合征存在变化.
研究的目的:
- 报告一个与ICI相关的延迟,燃烧的双M综合征的独特病例.
- 强调认识到这些综合征的亚急性表现的重要性.
- 强调多式联络成像在诊断和管理中的作用.
主要方法:
- 一名67岁的乳腺癌患者在ICI治疗后4个月出现了症状.
- 诊断工作包括实验室测试 (CK,AST,ALT,热素),心电图,心声学,冠状动脉血管学和内心肌活检.
- 治疗涉及脉冲类固醇和普得尼松缓和剂.
主要成果:
- 患者出现肌痛,虚弱,发烧和心脏酶升高.
- 内心肌活检证实了ICI相关心肌炎与特定的免疫标志物.
- 先进的成像显示治疗后的完整解脱.
结论:
- 与ICI相关的双M综合征是罕见的,高风险的,并且经常急性出现.
- 这一案例说明了延迟的,燃烧的呈现,需要临床警.
- 使用多模式成像即时诊断对于有利的结果至关重要.
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