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纳武利尤单抗致食管癌患者风湿免疫相关不良事件引发类风湿关节炎的诊断

Rheumatoid Arthritis Symptoms Diagnosed by Rheumatic Immune-related Adverse Events Caused by Nivolumab in a Patient with Esophageal Cancer.

机构信息

Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Japan.

Division of Respiratory Medicine and Rheumatology, Faculty of Medicine, Tottori University, Japan.

出版信息

Intern Med. 2023 Jan 15;62(2):215-220. doi: 10.2169/internalmedicine.9663-22. Epub 2022 Jun 21.

Abstract

This report described the case of a 70-year-old man who developed polyarthralgia after nivolumab treatment for recurrent esophageal cancer. Arthritis developed after initiating nivolumab therapy, and the patient tested positive for rheumatoid factor and anti-citrullinated peptide antibodies. The hand and elbow joints were already deformed, suggesting that he had had rheumatoid arthritis for several years and that the symptoms had only become apparent after nivolumab administration. This patient had rheumatoid arthritis, which was diagnosed as a nivolumab-induced rheumatic immune-related adverse event (rh-irAEs). Arthralgia during nivolumab administration can occur in rh-irAE cases. Patients should be assessed for autoimmune diseases before initiating immune checkpoint inhibitors.

摘要

本报告描述了一例 70 岁男性在接受纳武利尤单抗治疗复发性食管癌后出现多关节痛的病例。关节炎在开始纳武利尤单抗治疗后出现,患者类风湿因子和抗瓜氨酸化肽抗体检测阳性。手部和肘部关节已经变形,提示他患有类风湿关节炎多年,并且在纳武利尤单抗给药后症状才显现出来。该患者患有类风湿关节炎,被诊断为纳武利尤单抗引起的风湿免疫相关不良事件(rh-irAEs)。在纳武利尤单抗治疗期间可能会出现关节痛,这是 rh-irAE 病例中的一种表现。在开始免疫检查点抑制剂治疗前,应评估患者是否患有自身免疫性疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6196/9908395/2ff7e3ec2cce/1349-7235-62-0215-g001.jpg

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