结节性红斑作为纳武单抗诱导的类结节病反应的初始表现。
Erythema Nodosum as the Initial Presentation of Nivolumab-Induced Sarcoidosis-Like Reaction.
作者信息
Laroche Alexandre, Alarcon Chinchilla Evelyn, Bourgeault Emilie, Doré Marc-André
机构信息
1 Faculty of Medicine, Université Laval, Ville de Québec, QC, Canada.
2 Hôtel-Dieu de Lévis, Medicine department, Dermatology Division, Lévis, QC, Canada.
出版信息
J Cutan Med Surg. 2018 Nov/Dec;22(6):627-629. doi: 10.1177/1203475418776934. Epub 2018 May 17.
BACKGROUND
We report a case of nivolumab-related sarcoidosis-like syndrome that initially presented with erythema nodosum. Sarcoidosis development has been described in single and combination immunotherapy.
CASE PRESENTATION
A 68-year-old white woman with metastatic ocular amelanotic choroid melanoma was treated with nivolumab. The patient developed histologically confirmed erythema nodosum lesions and pulmonary granuloma sarcoidosis. Nivolumab was discontinued and the patient started ipilimumab therapy.
CONCLUSION
Sarcoidosis-like syndrome with lymphadenopathy is a rare adverse event that is important to recognize since it can be mistaken for metastatic disease progression. Tissue biopsy of new lesions during immunotherapy is an important step in patient evaluation.
背景
我们报告一例最初表现为结节性红斑的与纳武单抗相关的结节病样综合征病例。在单药及联合免疫治疗中均有结节病发生的报道。
病例介绍
一名68岁患有转移性眼无色素性脉络膜黑色素瘤的白人女性接受了纳武单抗治疗。该患者出现了经组织学证实的结节性红斑病变及肺部肉芽肿性结节病。停用纳武单抗后，患者开始接受伊匹单抗治疗。
结论
伴有淋巴结病的结节病样综合征是一种罕见的不良事件，因其可能被误诊为转移性疾病进展，所以认识到这一点很重要。免疫治疗期间对新病变进行组织活检是患者评估的重要步骤。
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