免疫检查点抑制剂的多腺体功能障碍:甲状腺功能低下,糖尿病和上腺功能不全的病例
Ranjini Vengilote1, Oyiyechukwu Onwudiwe2, Alshaima Yousef1
1Department of Medicine, Rochester General Hospital, Rochester Regional Health, Rochester, NY 14621, USA.
JCEM case reports
|February 25, 2026
概括
免疫检查点抑制剂 (ICI) 可以在转移性细胞癌 (RCC) 患者中引起多种内分泌毒性. 针对顺序性,多腺体免疫相关不良事件 (irAEs) 的警对于及时管理至关重要.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 改善了转移性细胞癌 (RCC) 的结果.
- ICI可以引起与免疫相关的不良事件 (irAEs),包括内分泌毒性.
- 内分泌IRAE可能会对长期治疗产生影响.
研究的目的:
- 在接受ICI治疗的RCC患者中呈现了一种连续的多腺体内分泌毒性病例.
- 强调在ICI治疗期间对正在演变的IRE保持警的重要性.
主要方法:
- 一个62岁的男性患有转移性透明细胞RCC的病例报告.
- 在ICI治疗期间内分泌IRAE (甲状腺炎,糖尿病,上腺功能不充分) 和炎症性关节炎的详细描述.
- 治疗干预措施的文件,包括激素替代和胰岛素治疗.
主要成果:
- 该患者发展了三种不同的内分泌IRAE:甲状腺功能低下,胰岛素依赖性糖尿病与酸性糖尿病,以及二次上腺功能不充分.
- 由于irrAEs的严重程度,ICI治疗被中止.
- 患者需要甲状腺激素替代剂,胰岛素和皮用于管理.
结论:
- 连续的多腺体内分泌毒性是RCC中ICI的潜在并发症.
- 临床医生必须警延迟或演变的irAE表现,即使没有自身抗体或放射性发现.
- 早期识别,多学科护理和长期随访对于管理ICI相关的内分泌病变至关重要.
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