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帕博利珠单抗诱发的一名结肠癌患者的心肌炎和胰腺炎:病例报告

Pembrolizumab-Induced Myocarditis and Pancreatitis in a Patient With Colon Cancer: A Case Report.

作者信息

Delgado-Lazo Victor, Abdelmottaleb Wael, Popescu-Martinez Andrea

机构信息

Medicine, Metropolitan Hospital Center, New York City, USA.

Oncology, Metropolitan Hospital Center, New York City, USA.

出版信息

Cureus. 2022 Jun 17;14(6):e26034. doi: 10.7759/cureus.26034. eCollection 2022 Jun.

Abstract

We present a unique case of immune checkpoint inhibitor (ICI)-induced myocarditis and acute pancreatitis in a patient with metastatic colon cancer after seven cycles of pembrolizumab. A 43-year-old male with stage IV colon cancer on pembrolizumab presented with acute onset of heart failure with severely decreased ejection fraction (EF), conduction abnormalities, and normal coronary arteries on cardiac catheterization. He was started on high-dose steroids for grade 3 immune-related myocarditis. Four days later he presented with abdominal pain consistent with acute pancreatitis, likely related to the immune checkpoint inhibitors as well, Pembrolizumab was discontinued permanently. Pembrolizumab is currently used to treat many types of advanced cancers with promising results; thus, clinicians need to be aware of the multiple organs and systems that can be affected after using ICIs.

摘要

我们报告了一例独特的病例,一名转移性结肠癌患者在接受七个周期的帕博利珠单抗治疗后,出现免疫检查点抑制剂(ICI)诱发的心肌炎和急性胰腺炎。一名43岁患有IV期结肠癌且正在接受帕博利珠单抗治疗的男性,出现急性心力衰竭,射血分数(EF)严重降低、传导异常,心脏导管检查显示冠状动脉正常。他因3级免疫相关性心肌炎开始接受大剂量类固醇治疗。四天后,他出现了与急性胰腺炎相符的腹痛,可能也与免疫检查点抑制剂有关,帕博利珠单抗被永久停用。帕博利珠单抗目前用于治疗多种类型的晚期癌症,效果良好;因此,临床医生需要意识到使用ICI后可能受到影响的多个器官和系统。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2e7/9205379/9e30233a8d29/cureus-0014-00000026034-i01.jpg

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