Miyashita Koichi, Kajikawa Hiroyuki, Utsunomiya Takaya, Hosaka Makoto, Naito Yutaka, Tomimoto Hidekazu
Department of Neurology, Suzuka Kaisei Hospital.
Department of Neurology, Mie University Graduate School of Medicine.
Rinsho Shinkeigaku. 2020 Nov 27;60(11):768-772. doi: 10.5692/clinicalneurol.cn-001443. Epub 2020 Oct 27.
A 74-year-old man was administered nivolumab to treat recurrent squamous cell carcinoma of the lungs. He developed fatigue, redness on the front of his neck, muscle weakness, and difficulty in swallowing after receiving the third course of nivolumab. Physical and neurological examinations showed proximal limb muscle weakness, periorbital erythema, and erythema of the front of his neck as well as fingers. Laboratory investigations revealed elevated serum CK and aldolase levels, and he was diagnosed with dermatomyositis. We initiated steroid pulse therapy and intravenous immunoglobulin therapy; however, he died of advanced lung cancer. Immune checkpoint inhibitor-induced neuromuscular disease is increasingly being observed in clinical practice. We report a rare case of dermatomyositis with squamous cell carcinoma of the lungs secondary to nivolumab treatment.
一名74岁男性接受纳武单抗治疗复发性肺鳞状细胞癌。在接受第三疗程纳武单抗治疗后,他出现了疲劳、颈部前方发红、肌肉无力和吞咽困难。体格检查和神经检查显示近端肢体肌肉无力、眶周红斑、颈部前方以及手指红斑。实验室检查发现血清肌酸激酶(CK)和醛缩酶水平升高,他被诊断为皮肌炎。我们启动了类固醇冲击疗法和静脉注射免疫球蛋白疗法;然而,他死于晚期肺癌。免疫检查点抑制剂诱导的神经肌肉疾病在临床实践中越来越多地被观察到。我们报告了一例罕见的因纳武单抗治疗继发肺鳞状细胞癌的皮肌炎病例。