Department of Emergency Medicine, Anesthesia and Critical Care Medicine, Michele and Pietro Ferrero Hospital, 12060 Verduno, Italy.
Research Training Innovation Infrastructure, Research and Innovation Department, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy.
Medicina (Kaunas). 2022 Jan 30;58(2):209. doi: 10.3390/medicina58020209.
Immunotherapy with immune checkpoint inhibitors represents nowadays a marked improvement in cancer treatment. Nevertheless, they can cause severe toxicities that put the patient at high risk, often requiring aggressive treatment. We present the case of a female patient who developed a severe immune-related adverse reaction to Pembrolizumab prescribed for melanoma treatment. Her array of symptoms, which presented a few days after last drug administration, consisted of severe neurological deficit, severe renal failure, polymyositis, and hyperthyroidism. Treatment required the immediate interruption of the trigger drug, infusion of high dose steroids, renal replacement therapy, plasmapheresis, and methimazole, as will be further discussed.
免疫检查点抑制剂的免疫疗法代表了癌症治疗的重大进展。然而，它们可能会引起严重的毒性，使患者面临高风险，往往需要积极治疗。我们介绍了一位女性患者的病例，她因黑色素瘤治疗而接受 Pembrolizumab 治疗后出现严重的免疫相关不良反应。她在最后一次用药几天后出现的一系列症状包括严重的神经功能缺损、严重的肾衰竭、多发性肌炎和甲状腺功能亢进。治疗需要立即中断触发药物，输注大剂量类固醇、肾脏替代治疗、血浆置换和甲巯咪唑，我们将进一步讨论。
