Samlowski W E, Ward J H, Craven C M, Freedman R A
Salt Lake City Veterans Administration Medical Center, UT.
Arch Pathol Lab Med. 1989 Aug;113(8):838-41.
We observed a patient who developed unusually severe myocardial dysfunction during therapy for renal cell carcinoma with high-dose interleukin-2 (IL-2). Although cardiac isoenzymes became markedly elevated shortly after the completion of 14 doses of IL-2 (100,000 U/kg of IL-2 every eight hours), serial electrocardiograms revealed only nonspecific changes. Echocardiography documented diffuse myocardial dysfunction, with akinesis of the anteroseptal region, suggestive of myocardial infarction. This anteroseptal hypokinesis persisted over a five-day period. The patient died unexpectedly and postmortem evaluation of the heart revealed a severe, diffuse lymphocytic, and eosinophilic myocarditis with myocyte necrosis, especially prominent in the anteroseptal region. This is the first histologically confirmed case of myocarditis reported, to our knowledge, in association with IL-2 therapy for cancer.
我们观察到一名在接受高剂量白细胞介素-2（IL-2）治疗肾细胞癌期间出现异常严重心肌功能障碍的患者。尽管在完成14剂IL-2治疗（每8小时100,000 U/kg的IL-2）后不久心脏同工酶显著升高，但系列心电图仅显示非特异性改变。超声心动图记录到弥漫性心肌功能障碍，前间隔区域运动减弱，提示心肌梗死。这种前间隔运动减弱持续了五天。患者意外死亡，心脏尸检显示严重的、弥漫性淋巴细胞性和嗜酸性心肌炎伴心肌细胞坏死，在前间隔区域尤为突出。据我们所知，这是首例经组织学证实与IL-2治疗癌症相关的心肌炎病例。
