免疫检查点抑制剂相关心肌炎与多系统免疫毒性在细胞癌
Raj Nandan Chennuri1, Makarand Madine1, Reshmanth Prathipati1
1Department of Internal Medicine, NYMC/St. Clare's and St. Mary's Hospital, Denville, New Jersey, USA.
JACC. Case reports
|February 23, 2026
概括
老年患者可能会经历早期,多系统免疫相关的毒性,包括心肌炎,来自免疫检查点抑制剂,如 pembrolizumab. 及时识别和皮质类固醇治疗对于控制这种罕见但严重的副作用至关重要.
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) 是对细胞癌的标准辅助疗法.
- 虽然ICI通常是安全的,但可以引起与免疫相关的不良事件,心肌炎是一种罕见但严重的并发症.
- 早期出现的ICI多系统毒性并不常见,特别是在老年患者中.
研究的目的:
- 在老年患者中报告早期发病的勃利祖马布相关心肌炎,多系统参与.
- 强调早期识别和迅速管理ICI诱导心脏毒性的重要性.
主要方法:
- 一个84岁的女性患者接受辅助 pembrolizumab 治疗细胞癌的病例报告.
- 患者出现呼吸障碍,左束支部阻塞,高位素,以及肌炎,肺炎和炎的迹象.
- 佩布罗利祖马布的治疗被停止,并给予高剂量的皮质类固醇.
主要成果:
- 患者在第二剂 pembrolizumab后不久就出现了症状.
- 心脏参与包括左捆分支阻塞和热素升高与轻度左心室功能障碍.
- 还观察到多系统性毒性 (肌炎,肺炎,炎).
- 用皮质类固醇治疗导致逐渐的临床改善.
结论:
- 这一案例说明了在老年患者中使用 pembrolizumab 可能导致早期和严重的多系统免疫相关毒性,包括心肌炎.
- 早期诊断和积极的免疫抑制疗法 (皮质类固醇) 对于ICI相关心肌炎的良好结果至关重要.
- 多学科管理对于解决复杂的ICI相关毒性至关重要.
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