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沃格特-小柳-原田样综合征并发派姆单抗治疗转移性黑色素瘤

Vogt-Koyanagi-Harada-like Syndrome Complicating Pembrolizumab Treatment for Metastatic Melanoma.

作者信息

Bricout Marion, Petre Adeline, Amini-Adle Mona, Bezza Widad, Seve Pascal, Kodjikian Laurent, Dalle Stéphane, Thomas Luc

机构信息

Departments of *Ophthalmology †Dermatology, LYON SUD Hospital Center, Hospices Civils of Lyon, Pierre Bénite Cedex Departments of ‡Internal Medicine §Ophthalmology, Croix-Rousse Hospital, Hospices Civils of Lyon, Lyon, France.

出版信息

J Immunother. 2017 Feb/Mar;40(2):77-82. doi: 10.1097/CJI.0000000000000154.

Abstract

Vogt-Koyanagi-Harada (VKH) syndrome is a rare condition implicating systemic immune reaction against melanocytes. The pathophysiology is unclear. A genetic predisposition has been suggested as HLA-DR4/DRB104 is more common among VKH patients. Drug induced VKH syndrome has been reported in advanced melanoma patients receiving immunotherapy, including ipilimumab and adoptive cell transfer of Tumor-Infiltrating Lymphocyte associated with IL-2. To date, no case of anti PD-1 -induced VKH syndrome has been described. We report here the case of a HLA-DR4/DRB104 patient successfully treated with anti PD-1 for advanced melanoma who developed a systemic immune reaction against melanocytes for whom we discuss a VKH-like syndrome diagnosis in a potentially genetically predisposed patient.

摘要

伏格特-小柳-原田(VKH)综合征是一种罕见疾病,涉及针对黑素细胞的全身性免疫反应。其病理生理学尚不清楚。由于HLA-DR4/DRB104在VKH患者中更为常见,因此有人提出存在遗传易感性。在接受免疫治疗的晚期黑色素瘤患者中,包括使用伊匹单抗以及与白细胞介素-2相关的肿瘤浸润淋巴细胞过继性细胞转移治疗的患者中,曾报道过药物诱导的VKH综合征。迄今为止,尚未有抗PD-1诱导的VKH综合征病例的描述。我们在此报告一例携带HLA-DR4/DRB104的晚期黑色素瘤患者,其接受抗PD-1治疗后成功治愈,但却出现了针对黑素细胞的全身性免疫反应,鉴于此患者可能存在遗传易感性,我们讨论了其VKH样综合征的诊断情况。

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