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帕博利珠单抗治疗所致的风湿性多肌痛

Polymyalgia rheumatica due to pembrolizumab therapy.

作者信息

Iskandar Andrew, Hwang Andrew, Dasanu Constantin A

机构信息

1 Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA.

2 Lucy Curci Cancer Center, Eisenhower Medical Center, Rancho Mirage, CA, USA.

出版信息

J Oncol Pharm Pract. 2019 Jul;25(5):1282-1284. doi: 10.1177/1078155218800386. Epub 2018 Sep 24.

Abstract

Pembrolizumab is a humanized anti-programmed cell death 1 antibody used for the therapy of several malignancies. While autoimmune adverse events are not uncommon with this agent, they are typically mild and self-limiting. Severe autoimmunity is rare but can be life-threatening. Herein, we describe a unique case of severe proximal muscle weakness and joint pain shortly after beginning therapy with pembrolizumab. Work-up revealed elevated pro-inflammatory markers leading to the diagnosis of polymyalgia rheumatica. Steroids allowed for resolution of the joint pain. We call for awareness of this rare autoimmune toxicity with pembrolizumab.

摘要

帕博利珠单抗是一种人源化抗程序性细胞死亡1抗体,用于治疗多种恶性肿瘤。虽然使用这种药物时自身免疫性不良事件并不罕见,但通常症状较轻且具有自限性。严重的自身免疫反应很少见,但可能危及生命。在此,我们描述了一例在开始使用帕博利珠单抗治疗后不久出现严重近端肌无力和关节疼痛的独特病例。检查发现促炎标志物升高,从而诊断为风湿性多肌痛。使用类固醇后关节疼痛得以缓解。我们呼吁提高对帕博利珠单抗这种罕见自身免疫毒性的认识。

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