Liu Kai, Bao Jian-Feng, Wang Tao, Yang Hao, Xu Bao-Ping
Department of Radiotherapy, Traditional Chinese Hospital of Lu'an affiliated to Anhui University of Traditional Chinese Medicine, Lu'an 237000, Anhui Province, China.
Department of Immunology, Xixi Hospital of Hangzhou affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou 310023, Zhejiang Province, China.
World J Clin Cases. 2022 Jun 26;10(18):6198-6204. doi: 10.12998/wjcc.v10.i18.6198.
Camrelizumab (SHR-1210), an immune checkpoint inhibitor, is clinically used as a therapeutic option for various types of tumors. However, reports of adverse reactions associated with camrelizumab are gradually increasing. Anaphylactic shock due to camrelizumab has not been reported previously, until now. We report here, for the first time, a case of anaphylactic shock associated with camrelizumab in a patient with esophageal squamous cell carcinoma.
An 84-year-old male esophageal cancer patient received radiotherapy and chemotherapy 11 years ago. He was diagnosed with advanced esophageal squamous cell carcinoma with liver metastasis (TxN1M1) and received the first immunotherapy (camrelizumab 200 mg/each time, once every 3 wk) dose in December 2020, with no adverse reactions. Three weeks later, a generalized rash was noted on the chest and upper limbs; palpitations and breathing difficulties with a sense of dying occurred 10 min after the patient had been administered with the second camrelizumab therapy. Electrocardiograph monitoring revealed a 70 beats/min pulse rate, 69/24 mmHg (1 mmHg = 0.133 kPa) blood pressure, 28 breaths/min respiratory rate, and 86% pulse oximetry in room air. The patient was diagnosed with anaphylactic shock and was managed with intravenous fluid, adrenaline, dexamethasone sodium phosphate, calcium glucosate, and noradrenaline. Approximately 2 h after treatment, the patient's anaphylactic shock symptoms had been completely relieved.
Due to the widespread use of camrelizumab, attention should be paid to anti-programmed cell death 1 antibody therapy-associated hypersensitivity or anaphylactic shock.
卡瑞利珠单抗（SHR-1210）是一种免疫检查点抑制剂，在临床上用作多种类型肿瘤的治疗选择。然而，与卡瑞利珠单抗相关的不良反应报告正逐渐增多。此前尚未有卡瑞利珠单抗导致过敏性休克的报道，直至现在。我们在此首次报告一例食管鳞状细胞癌患者发生与卡瑞利珠单抗相关的过敏性休克病例。
一名84岁男性食管癌患者11年前接受过放疗和化疗。他被诊断为伴有肝转移的晚期食管鳞状细胞癌（TxN1M1），并于2020年12月接受首次免疫治疗（卡瑞利珠单抗200mg/次，每3周1次），未出现不良反应。三周后，胸部和上肢出现全身性皮疹；在患者接受第二次卡瑞利珠单抗治疗10分钟后，出现心悸、呼吸困难并有濒死感。心电图监测显示心率70次/分钟，血压69/24mmHg（1mmHg = 0.133kPa），呼吸频率28次/分钟，室内空气中脉搏血氧饱和度86%。患者被诊断为过敏性休克，并接受了静脉补液、肾上腺素、地塞米松磷酸钠、葡萄糖酸钙和去甲肾上腺素治疗。治疗约2小时后，患者的过敏性休克症状完全缓解。
由于卡瑞利珠单抗的广泛应用，应关注抗程序性细胞死亡1抗体治疗相关的超敏反应或过敏性休克。
