免疫检查点抑制剂相关心肌炎模仿Takotsubo心肌病变
Satoru Hiromasa1, Yoshimichi Ueda2, Takuya Mayumi1
1Department of Cardiology, Keiju Medical Center, Nanao, Japan.
JACC. Case reports
|November 15, 2025
概括
布罗利祖马布诱导的心肌炎是一种罕见的与免疫相关的不良事件,可以模仿Takotsubo心肌病变. 通过心脏内膜活检和类固醇治疗进行早期诊断对于接受免疫检查点抑制剂的患者改善结果至关重要.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
背景情况:
- 布罗利祖马布诱导的心肌炎是一种罕见但可能致命的免疫相关不良事件.
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 与ICI相关的心肌炎是一个诊断挑战.
研究的目的:
- 为了突出布罗利祖马布诱导心肌炎模仿塔科苏博心肌病的潜力.
- 强调ICI相关心肌炎的诊断程序和早期治疗的重要性.
- 在患有肺腺癌的患者中审查ICI相关心肌炎病例.
主要方法:
- 一名72岁的妇女患有晚期肺腺癌,接受了多种疗法,包括pembrolizumab.
- 临床表现包括恶心,厌食症和广泛的ST段升高的心电图发现.
- 诊断工作包括冠状动脉血管造影,左心室造影和内心肌组织活检.
主要成果:
- 冠状动脉扫描显示没有显著的狭窄;左心室扫描显示了一个角气球的模式,暗示了Takotsubo心肌病.
- 心内膜活检证实了布罗利祖马布诱导的心肌炎.
- 高剂量的皮质类固醇导致心脏功能得到改善,但潜在的恶性瘤进展.
结论:
- 免疫检查点抑制剂相关心肌炎可以异常呈现,模仿Takotsubo心肌病变.
- 在ICI患者中,持续的心电图变化或生物标志物升高需要考虑心肌炎.
- 内心肌组织活检对于诊断至关重要,早期的类固醇治疗改善了结果.
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