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一例因免疫检查点抑制剂纳武单抗导致的急性心力衰竭病例。

A Case of Acute Heart Failure due to Immune Checkpoint Blocker Nivolumab.

作者信息

Sharma Munish, Suero-Abreu Giselle A, Kim Bernard

机构信息

Department of Advanced Heart Failure and Pulmonary Hypertension, Hackensack University Medical Center, NJ, USA.

Department of Internal Medicine, Rutgers-NJMS, NJ, USA.

出版信息

Cardiol Res. 2019 Apr;10(2):120-123. doi: 10.14740/cr838. Epub 2019 Apr 11.

Abstract

Immune checkpoint inhibitors can be potentially cardiotoxic. It has not been frequently reported in the literature. Cardiomyopathy with these agents can have early onset and may start with non-specific symptoms like fatigue, weakness before presenting with obvious features of acute heart failure. Rapid progression and fulminant course of this disease necessitate high index of clinical suspicion and early diagnosis. High-dose steroids should be instituted early to blunt the immune response against myocardium. Further bigger studies are needed to fully understand the pathogenesis of this condition.

摘要

免疫检查点抑制剂可能具有潜在的心脏毒性。文献中对此报道并不常见。使用这些药物引发的心肌病可能起病较早,在出现急性心力衰竭的明显特征之前,可能先出现疲劳、虚弱等非特异性症状。这种疾病进展迅速且病情凶险,需要高度的临床怀疑和早期诊断。应尽早使用大剂量类固醇药物以抑制针对心肌的免疫反应。需要进一步开展更大规模的研究,以全面了解这种疾病的发病机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de33/6469913/ce2a043ad6a3/cr-10-120-g001.jpg

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