超越中性衰竭发烧:严重的多器官免疫相关毒性诱导Pembrolizumab
Marta Anastácio1, Tiago Pina Cabral2, Marta Roldão3
1Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisbon, PRT.
Cureus
|February 3, 2026
概括
免疫检查点抑制剂 (ICI) 可以引起严重的毒性. 早期识别和积极治疗pembrolizumab诱导的多器官毒性,包括上腺功能衰竭和结肠炎,对于患者的生存至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗.
- ICI可以导致与免疫相关的毒性,呈现为瘤紧急情况.
- 这些毒性可能很严重,难以诊断.
研究的目的:
- 报告一例严重的多器官免疫相关毒性病例,该病例是由 pembrolizumab.
- 强调迅速识别和管理ICI相关紧急情况的重要性.
主要方法:
- 一个病例报告,一名49岁的女性患有三阴性乳腺癌,接受新辅助剂pembrolizumab.
- 临床表现包括休克,全细胞减肥,急性损伤和低血症.
- 在排除感染性原因后,诊断出pembrolizumab诱导的多器官毒性.
主要成果:
- 这位患者出现了3级上腺功能不全与休克,3级大肠炎,3级全细胞减肥和2级甲状腺功能低下.
- 用甲基prednisolone,filgrastim和levothyroxine治疗导致显著的临床改善.
- 佩布罗利祖马布的治疗被永久停止.
结论:
- 布罗利祖马布可以诱导严重的,多器官免疫相关的不良事件.
- 早期诊断和积极的管理,包括皮质类固醇治疗,至关重要.
- 在癌症患者中,对ICI诱导的毒性保持警至关重要.
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