Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, Florida, USA
Internal Medicine, University of Florida, Gainesville, Florida, USA.
BMJ Case Rep. 2023 Feb 20;16(2):e253647. doi: 10.1136/bcr-2022-253647.
Trastuzumab-deruxtecan (T-DXd) is a novel antibody drug conjugate that has improved treatment outcomes in patients with ERBB2-positive cancer, including locally advanced or metastatic gastric and gastro-oesophageal junction adenocarcinoma. One of the reported side effects of this medication is drug-induced pneumonitis. We present in this case report, a diagnostic dilemma of a patient presenting with clinical and radiographical features of drug-induced pneumonitis but was found to have pneumocystis jirovecii pneumonia (PJP). Our case is the first of PJP in a patient treated with T-DXd, highlighting the increasing incidence of this opportunistic infection in patients with solid malignancy. It also highlights the clinical and radiographical similarities between the PJP and drug-induced pneumonitis.
曲妥珠单抗-德鲁替康（T-DXd）是一种新型抗体药物偶联物，可改善 ERBB2 阳性癌症患者的治疗效果，包括局部晚期或转移性胃和胃食管交界处腺癌。该药物的报告副作用之一是药物性肺炎。我们在本病例报告中介绍了一位患者的诊断难题，该患者具有药物性肺炎的临床和影像学特征，但被发现患有肺孢子菌肺炎（PJP）。我们的病例是首例接受 T-DXd 治疗的患者发生 PJP，突显了实体恶性肿瘤患者中这种机会性感染的发病率不断增加。它还突出了 PJP 和药物性肺炎之间的临床和影像学相似性。
