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[免疫介导性胃炎患者的巨细胞病毒再激活]

[Cytomegalovirus reactivation in patients with immune-mediated gastritis].

作者信息

Paredes-Ruiz Diana, López-López Flora, Núñez-Sobrino Juan Antonio, Gómez-Martin Carlos, Díaz-Pedroche Carmen, Lizasoain Manuel

机构信息

Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, España.

Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Madrid, España.

出版信息

Enferm Infecc Microbiol Clin (Engl Ed). 2023 May;41(5):298-300. doi: 10.1016/j.eimce.2022.03.017. Epub 2023 Jan 19.

Abstract

INTRODUCTION

Reactivation of cytomegalovirus can complicate the evolution of patients with gastritis induced by immune checkpoint inhibitors.

METHODS

The experience in our center is described and a review of the literature is performed.

RESULTS

A case of severe gastritis induced by treatment with a programmed cell death receptor-1 (anti-PD1) inhibitor, associated with reactivation of cytomegalovirus (CMV) is described. In the systematic review, we identified 5 cases of immune-related gastritis associated with CMV reactivation. Ganciclovir treatment contributed to clinical improvement in most patients.

CONCLUSION

The early identification of a CMV infection in patients with severe or refractory immune-related gastritis will allow the initiation of targeted treatment, and may avoid increasing immunosuppressive therapy.

摘要

引言

巨细胞病毒再激活会使免疫检查点抑制剂诱发的胃炎患者病情复杂化。

方法

描述了我们中心的经验并进行了文献综述。

结果

描述了1例由程序性细胞死亡受体1(抗PD1)抑制剂治疗诱发的严重胃炎病例,该病例与巨细胞病毒(CMV)再激活有关。在系统综述中,我们确定了5例与CMV再激活相关的免疫相关性胃炎病例。更昔洛韦治疗使大多数患者的临床症状得到改善。

结论

早期识别严重或难治性免疫相关性胃炎患者的CMV感染将有助于启动针对性治疗,并可能避免增加免疫抑制治疗。

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