免疫检查点抑制剂诱发的腱鞘炎：一例报告及文献综述
Tenosynovitis Induced by an Immune Checkpoint Inhibitor: A Case Report and Literature Review.
作者信息
Murakami Shoko, Nagano Tatsuya, Nakata Kyosuke, Onishi Akira, Umezawa Kanoko, Katsurada Naoko, Yamamoto Masatsugu, Tachihara Motoko, Kobayashi Kazuyuki, Nishimura Yoshihiro
机构信息
Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan.
出版信息
Intern Med. 2019 Oct 1;58(19):2839-2843. doi: 10.2169/internalmedicine.2556-19. Epub 2019 Jun 27.
A 51-year-old man underwent second-line treatment for non-small-cell lung cancer (NSCLC) with the immune checkpoint inhibitor (ICI) pembrolizumab. On day 2 after two cycles of pembrolizumab, he presented with edema limited to the left third, fourth, and fifth fingers. Based on symptoms, laboratory results, and contrast-enhanced magnetic resonance imaging (MRI) findings, we diagnosed him with tenosynovitis. We prescribed oral prednisolone (0.5 mg/kg/day), and pembrolizumab was continued. Prednisolone immediately relieved the symptoms, and the tumor was still shrinking on day 21 after eight cycles of pembrolizumab. ICI-induced tenosynovitis was managed while continuing ICI usage, suggesting that 0.5 mg/kg/day prednisone might be effective for tenosynovitis without ICI cessation.
一名51岁男性接受了免疫检查点抑制剂（ICI）帕博利珠单抗用于非小细胞肺癌（NSCLC）的二线治疗。在接受两个周期帕博利珠单抗治疗后的第2天，他出现了仅局限于左手第三、第四和第五指的水肿。根据症状、实验室检查结果以及对比增强磁共振成像（MRI）结果，我们诊断他患有腱鞘炎。我们开具了口服泼尼松龙（0.5 mg/kg/天），并继续使用帕博利珠单抗。泼尼松龙立即缓解了症状，在接受八个周期帕博利珠单抗治疗后的第21天，肿瘤仍在缩小。在继续使用ICI的同时对ICI诱导的腱鞘炎进行了处理，这表明0.5 mg/kg/天的泼尼松可能对腱鞘炎有效且无需停用ICI。
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