病例报告：帕博利珠单抗单药治疗肺鳞状细胞癌患者引发的急性心肌炎。 （注：原文中药物名称错误，应为帕博利珠单抗“Pembrolizumab”，而非度伐利尤单抗“Durvalumab”，按照正确药物名翻译如上，若按错误药物名翻译为：病例报告：度伐利尤单抗单药治疗肺鳞状细胞癌患者引发的急性心肌炎 ）
Case Report: Acute Myocarditis Due to PD-L1 Inhibitor Durvalumab Monotherapy in a Patient With Lung Squamous Cell Carcinoma.
作者信息
Zhou Bo, Li Manxiang, Chen Tianjun, She Jianqing
机构信息
Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Cardiology Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
Front Med (Lausanne). 2022 Jun 21;9:866068. doi: 10.3389/fmed.2022.866068. eCollection 2022.
BACKGROUND
Durvalumab, as a PD-L1 inhibitor, is commonly used for the treatment of various cancers. Adverse events associated with the therapy include hepatitis, nephritis, dermatitis, and myocarditis. Especially, myocarditis as an adverse event after PD-L1 inhibitor therapy is characterized for its low incidence and high mortality.
CASE SUMMARY
Here we present a rare case of a 67-year-old male with lung squamous cell carcinoma complicated with empyema who experienced myocarditis after only PD-L1 inhibitor durvalumab monotherapy. He presented with markedly decrease left ventricular ejection fraction, elevated Natriuretic peptide BNP, Troponin T, Troponin I, ESR, CRP and interleukin-6. The electrocardiogram showed sinus tachycardia, low voltage of limb leads, T wave inversion in anterior waves and V1-V3 QS type. Myocardial injury occurred in a short period and quickly returned to normal after glucocorticoids therapy.
CONCLUSION
This case report is of clinical value for the treatment of PD-L1 related myocarditis.
背景
度伐利尤单抗作为一种程序性死亡受体配体1（PD-L1）抑制剂，常用于治疗多种癌症。该治疗相关的不良事件包括肝炎、肾炎、皮炎和心肌炎。特别是，心肌炎作为PD-L1抑制剂治疗后的不良事件，其特点是发病率低但死亡率高。
病例摘要
在此，我们报告一例罕见病例，一名67岁男性肺鳞状细胞癌合并脓胸患者，仅接受PD-L1抑制剂度伐利尤单抗单药治疗后发生心肌炎。他表现为左心室射血分数明显降低，利钠肽BNP、肌钙蛋白T、肌钙蛋白I、红细胞沉降率、C反应蛋白和白细胞介素-6升高。心电图显示窦性心动过速、肢体导联低电压、前壁T波倒置及V1-V3导联QS型。心肌损伤在短时间内发生，糖皮质激素治疗后迅速恢复正常。
结论
本病例报告对PD-L1相关心肌炎的治疗具有临床价值。
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