Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan.
Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
Immunotherapy. 2020 Apr;12(6):373-378. doi: 10.2217/imt-2020-0061. Epub 2020 Apr 21.
Tuberculosis (TB) is considered to be an adverse effect of treatment with immune checkpoint inhibitors. Our case was a 75-year-old woman diagnosed with unresectable stage III non-small-cell lung cancer. After radical chemoradiotherapy was completed, durvalumab was initiated as a consolidation therapy. However, since chest CT showed appearances of infiltration shadows scattered in the periphery of the lungs after five doses of immunotherapy, duruvalumab was discontinued. 6 weeks later, the patient was aware of intermittent fever. Chest CT scan showed the appearance of a tree-in-bud pattern in the right lung. Acid-fast bacilli stain of sputum was positive and the PCR test was positive for . Duruvalumab as PD-L1 blockade may activate TB.
结核病（TB）被认为是免疫检查点抑制剂治疗的不良反应。我们的病例是一位 75 岁女性，诊断为不可切除的 III 期非小细胞肺癌。根治性放化疗完成后，开始使用度伐鲁单抗作为巩固治疗。然而，由于胸部 CT 显示免疫治疗 5 剂后肺部周围出现浸润阴影，度伐鲁单抗被停用。6 周后，患者出现间歇性发热。胸部 CT 扫描显示右肺呈树芽征。痰抗酸杆菌染色阳性，PCR 检测 阳性。度伐鲁单抗作为 PD-L1 阻断剂可能激活 TB。
