Department of Medicine, Gold Coast University Hospital, Southport, QLD, Australia
School of Medicine, Griffith University, Gold Coast, QLD, Australia.
BMJ Case Rep. 2021 Feb 1;14(2):e237217. doi: 10.1136/bcr-2020-237217.
Immune checkpoint inhibitors (ICIs) are increasingly used to treat certain malignancies due to their higher efficacy compared with conventional chemotherapy. As familiarity with these agents increases, it is becoming apparent that a significant number of patients treated with ICIs experience adverse events. With time, more immune-related adverse events (IRAEs) are being recognised. It is important to be vigilant for IRAEs and recognise that a patient may have multiple IRAEs affecting multiple organ systems. Common cardiovascular adverse events associated with ICIs include myocarditis, arrhythmias and pericarditis. This case report identifies a patient presenting with takotsubo syndrome followed by ketoacidosis (associated with sodium-glucose transport protein 2 (SGLT2) inhibitor) in the setting of combination ipilimumab and nivolumab therapy for metastatic melanoma.
免疫检查点抑制剂 (ICIs) 由于其与传统化疗相比具有更高的疗效，因此越来越多地用于治疗某些恶性肿瘤。随着对这些药物的了解增加，越来越明显的是，相当数量的接受 ICI 治疗的患者会出现不良反应。随着时间的推移，越来越多的免疫相关不良事件 (IRAEs) 被认识到。警惕 IRAEs 并认识到患者可能会出现影响多个器官系统的多种 IRAEs 非常重要。与 ICI 相关的常见心血管不良事件包括心肌炎、心律失常和心包炎。本病例报告确定了一名患者在转移性黑色素瘤的联合 ipilimumab 和 nivolumab 治疗中出现 tako-tsubo 综合征，随后出现酮症酸中毒（与钠-葡萄糖转运蛋白 2 (SGLT2) 抑制剂相关）。
