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阿替利珠单抗治疗转移性尿路上皮癌患者引起的肌炎和心肌炎。

Atezolizumab-induced myositis and myocarditis in a patient with metastatic urothelial carcinoma.

机构信息

Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.

Critical Care Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA.

出版信息

BMJ Case Rep. 2020 Dec 9;13(12):e236357. doi: 10.1136/bcr-2020-236357.

Abstract

Immune checkpoint inhibitors have revolutionised cancer therapy in the past decade. Although they have been indicated to treat a diverse range of malignant neoplasms, they are also associated with various immune-related adverse effects. We report the case of a 74-year-old man with a history of urothelial carcinoma who had atezolizumab-induced myocarditis and myositis resulting in acute hypercapnic respiratory failure, despite the discontinuation of atezolizumab and aggressive treatment with corticosteroids. This case highlights the importance of a multidisciplinary approach for early diagnosis and treatment of immune-related adverse events. Physicians must be aware of the risks associated with immune checkpoint inhibitors and have a basic knowledge regarding their management.

摘要

免疫检查点抑制剂在过去十年中彻底改变了癌症治疗。虽然它们已被证实可用于治疗多种恶性肿瘤,但它们也与各种免疫相关的不良反应有关。我们报告了一例 74 岁男性病例,该患者患有膀胱癌,在停用阿替利珠单抗和接受皮质类固醇积极治疗后,仍因阿替利珠单抗诱导的心肌炎和肌炎导致急性高碳酸血症呼吸衰竭。本病例强调了多学科方法对早期诊断和治疗免疫相关不良事件的重要性。医生必须了解免疫检查点抑制剂相关的风险,并对其管理有基本的了解。

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