Kwok Timothy Shun Him, Bell Mary Jane
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
BMJ Case Rep. 2019 Feb 27;12(2):e227995. doi: 10.1136/bcr-2018-227995.
Nivolumab is an immune checkpoint inhibitor that is used in the treatment of a variety of cancers in the adjuvant or metastatic setting. Adverse effects include non-specific activation of T cells, leading to immune-related adverse events in downstream organs. We present a case of a 36-year-old man with unresectable oropharyngeal squamous cell carcinoma who developed nivolumab-induced rheumatoid arthritis. As immune checkpoint inhibitor use is becoming widespread in the medical oncology domain, the purpose of this case report is to increase awareness of an increasingly common cause of rheumatic disease and to alert clinicians to consider immunotherapy in their differential diagnosis of polyarthritis. This case also highlights the importance of working in an interdisciplinary manner to enhance cancer care for the patient as well as to increase awareness of the potential adverse effects of immunotherapy in patients with cancer.
纳武单抗是一种免疫检查点抑制剂，用于辅助或转移性环境下多种癌症的治疗。不良反应包括T细胞的非特异性激活，导致下游器官出现免疫相关不良事件。我们报告一例36岁男性不可切除口咽鳞状细胞癌患者，该患者发生了纳武单抗诱导的类风湿关节炎。随着免疫检查点抑制剂在医学肿瘤学领域的广泛应用，本病例报告的目的是提高对这种日益常见的风湿病病因的认识，并提醒临床医生在多关节炎的鉴别诊断中考虑免疫治疗。本病例还强调了以跨学科方式开展工作的重要性，以加强对患者的癌症护理，并提高对癌症患者免疫治疗潜在不良反应的认识。
