一名患有难治性免疫相关性结肠炎患者的巨细胞病毒性小肠结肠炎
Cytomegalovirus Enterocolitis in a Patient with Refractory Immune-Related Colitis.
作者信息
Furuta Yoki, Miyamoto Hideaki, Naoe Hideaki, Shimoda Miki, Hinokuma Yukari, Miyamura Tomohiro, Miyashita Azusa, Fukushima Satoshi, Tanaka Motohiko, Sasaki Yutaka
机构信息
Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Department of Dermatology and Plastic Surgery, Kumamoto University, Kumamoto, Japan.
出版信息
Case Rep Gastroenterol. 2020 Feb 25;14(1):103-109. doi: 10.1159/000506186. eCollection 2020 Jan-Apr.
Although most immune-related adverse events (irAEs) secondary to immune checkpoint inhibitors can be managed with immunosuppressive therapies; they can induce reactivation of infectious diseases, including cytomegalovirus (CMV). Here, we show a case of CMV enterocolitis during steroid therapy for an irAE. A 77-year-old man with unresectable malignant melanoma was treated with ipilimumab. He suffered from immune-related colitis (irColitis) and was treated with methylprednisolone. Although corticosteroids initially improved his symptoms, CMV reactivation occurred and colitis was exacerbated. Antiviral therapy improved his symptoms without augmenting the immunosuppressive therapy. CMV colitis should be considered when a patient with irColitis shows resistance to immunosuppressive therapy.
尽管大多数免疫检查点抑制剂继发的免疫相关不良事件（irAE）可用免疫抑制疗法处理，但它们可诱发包括巨细胞病毒（CMV）在内的传染病再激活。在此，我们展示了1例在使用类固醇治疗irAE期间发生的CMV小肠结肠炎病例。1名患有不可切除恶性黑色素瘤的77岁男性接受了伊匹单抗治疗。他患上了免疫相关结肠炎（irColitis），并接受了甲泼尼龙治疗。尽管皮质类固醇最初改善了他的症状，但CMV再激活发生且结肠炎加重。抗病毒治疗改善了他的症状，而无需加强免疫抑制治疗。当irColitis患者对免疫抑制治疗表现出抵抗时，应考虑CMV结肠炎。
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