Oristrell Gerard, Bañeras Jordi, Ros Javier, Muñoz Eva
Department of Cardiology, Hospital Universitario Vall d'Hebrón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Paseo Vall d'Hebrón, Barcelona, Spain.
Department of Oncology, Hospital Universitario Vall d'Hebrón, Vall d'Hebrón Institute of Oncology, Paseo Vall d'Hebrón, Barcelona, Spain.
Eur Heart J Case Rep. 2018 Apr 3;2(2):yty038. doi: 10.1093/ehjcr/yty038. eCollection 2018 Jun.
Patients who receive or have received anti-programmed cell-death-1 (PD-1) monoclonal antibodies can develop immune-related adverse events due to activation of the immune system.
We report a case of a patient who received pembrolizumab and presented with cardiac tamponade. Despite pericardial drainage, she persisted with refractory arterial hypotension due to secondary adrenal insufficiency. After initiating corticosteroid therapy, the patient recovered successfully.
The association of pericarditis, hypophysitis and thyroid dysfunction support the diagnosis of a life-threatening immune-related adverse event due to pembrolizumab. In case of immune-related adverse events secondary to anti-PD-1 monoclonal antibodies, corticosteroid therapy should be promptly initiated in order to avoid major complications.
接受或已接受抗程序性细胞死亡蛋白1（PD-1）单克隆抗体治疗的患者，可能会因免疫系统激活而发生免疫相关不良事件。
我们报告一例接受帕博利珠单抗治疗后出现心脏压塞的患者。尽管进行了心包引流，但由于继发性肾上腺功能不全，她持续存在难治性动脉低血压。开始使用皮质类固醇治疗后，患者成功康复。
心包炎、垂体炎和甲状腺功能障碍的关联支持了因帕博利珠单抗导致的危及生命的免疫相关不良事件的诊断。对于抗PD-1单克隆抗体继发的免疫相关不良事件，应立即开始皮质类固醇治疗，以避免严重并发症。
