Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Japan.
Intern Med. 2021 Dec 15;60(24):3941-3945. doi: 10.2169/internalmedicine.7425-21. Epub 2021 Jun 19.
Pembrolizumab is a monoclonal antibody with anti-tumor effects. Only a few reports have previously described retrobulbar optic neuritis induced by pembrolizumab. We herein report the case of a 63-year-old man with advanced lung adenocarcinoma who received cisplatin, pemetrexed, and pembrolizumab combination therapy for six months. Following treatment, a visual field test showed a left central scotoma. Imaging studies showed left optic neuritis without brain metastasis. Blood tests showed an elevated serum creatinine level. He was diagnosed with retrobulbar optic neuritis and pembrolizumab-induced renal failure. After receiving corticosteroid treatment, his renal function rapidly improved. The optic neuritis improved somewhat, but it was not adequately resolved.
派姆单抗是一种具有抗肿瘤作用的单克隆抗体。以前只有少数报告描述过派姆单抗引起的球后视神经炎。本文报告了 1 例 63 岁男性，患有晚期肺腺癌，接受顺铂、培美曲塞和派姆单抗联合治疗 6 个月。治疗后，视野检查显示左眼中央性暗点。影像学检查显示左侧视神经炎，无脑转移。血液检查显示血清肌酐水平升高。他被诊断为球后视神经炎和派姆单抗引起的肾衰竭。接受皮质类固醇治疗后，他的肾功能迅速改善。视神经炎有所改善，但并未完全缓解。
