在使用PD-1抑制剂后出现肌痛性表现:CD8+肌痛性炎,肌痛性炎或两者兼而有之?
Selen Ucem1, Gulshan Yunisova2, Eser Bulus1
1Department of Neurology, Koç University Hospital, İstanbul, TUR.
Cureus
|March 16, 2026
概括
免疫检查点抑制剂 (ICI) 可以导致神经肌肉问题. 诊断是具有挑战性的,因为肌肉炎和肌痛症的症状重叠,往往需要即使没有抗体,也需要进行pyridostigmine试验.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以诱导免疫介导的神经肌肉并发症.
- 肌痛性肌炎和肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛性肌痛
研究的目的:
- 分析抗编程死亡-1 (PD-1) 治疗后出现神经肌肉症状的患者的临床特征,诊断结果和结果.
- 为了区分ICI相关的肌肉炎和严重肌痛性肌痛炎,特别是在血清阴性患者中.
主要方法:
- 对五名接受抗PD-1治疗的患者进行了回顾性分析.
- 对临床数据,实验室发现,肌电图,肌肉活检,治疗方法和结果的审查.
- 对诊断标记物的评估,包括抗体检测,电肌图和肌肉活检.
主要成果:
- 患者表现为眼球骨弱,消化不良,四肢疲软和呼吸衰竭.
- 大多数患者的血清测试中,肌痛性骨髓灰质炎的检测结果呈阴性.
- 电肌图显示了肌源性发现,肌肉活检显示了CD8+T细胞透.
- 皮里多斯蒂格明的反应性和波动的症状有助于诊断共存的肌痛症.
结论:
- 与ICI相关的神经肌肉综合征往往模仿肌,但主要是CD8+T细胞介导的肌炎.
- 波动的症状和皮里多斯提格明反应是区分肌炎和肌痛症的关键.
- 建议在ICI相关的呼吸道或腹筋恶化,甚至在血清阴性病例,以指导治疗,进行一项pyridostigmine试验.
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