Yasuda Yuichiro, Urata Yoshiko, Tohnai Rie, Ito Shoichi, Kawa Yoshitaka, Kono Yuko, Hattori Yoshihiro, Tsuda Masahiro, Sakuma Toshiko, Negoro Shunichi, Satouchi Miyako
Department of Thoracic Oncology, Hyogo Cancer Center, Japan.
Department of Gastroenterological Oncology, Hyogo Cancer Center, Japan.
Intern Med. 2018 May 1;57(9):1269-1272. doi: 10.2169/internalmedicine.9230-17. Epub 2017 Dec 27.
We herein report a case of immune-related colitis induced by the long-term use of nivolumab. A 62-year-old Japanese man was treated with nivolumab at 3 mg/kg every 2 weeks for advanced lung adenocarcinoma. The patient was admitted to our hospital due to non-bloody watery diarrhea after the 70th dose of nivolumab. A biopsy specimen of the colon mucosa revealed evidence of colitis with cryptitis and crypt microabscesses. He was diagnosed with immune-related colitis and started on predonisolone 60 mg/day. Subsequently, his symptoms remarkably resolved. Consideration of immune-related adverse events up to several years after the initiation of nivolumab is important.
我们在此报告一例因长期使用纳武单抗诱发的免疫相关性结肠炎病例。一名62岁的日本男性因晚期肺腺癌接受每2周一次、剂量为3mg/kg的纳武单抗治疗。在第70次注射纳武单抗后,该患者因非血性水样腹泻入院。结肠黏膜活检标本显示有结肠炎证据,伴有隐窝炎和隐窝微脓肿。他被诊断为免疫相关性结肠炎,并开始服用泼尼松龙60mg/天。随后,他的症状明显缓解。在开始使用纳武单抗后的数年中都要考虑免疫相关不良事件,这一点很重要。