Nishimura Yuki, Yamanaka Kazuaki, Kato Taigo, Hatano Koji, Kawashima Atsunari, Fukuhara Shinichiro, Uemura Motohide, Imamura Ryoichi, Nonomura Norio
Department of Urology Osaka University Graduate School of Medicine Suita Osaka Japan.
IJU Case Rep. 2022 Nov 30;6(2):101-105. doi: 10.1002/iju5.12560. eCollection 2023 Mar.
Since the approval of immune checkpoint inhibitors for renal cell carcinoma treatment, therapeutic efficacy has been enhanced. However, although autoimmune-related side effects may occur, rheumatoid immune-related adverse events seldom develop.
A 78-year-old Japanese man with renal cell carcinoma developed pancreatic and liver metastases after bilateral partial nephrectomy and was treated with ipilimumab and nivolumab. After 22 months, he developed arthralgia in limbs and knee joints, accompanied by limb swelling. The diagnosis was seronegative rheumatoid arthritis. Nivolumab was discontinued, and prednisolone was initiated, quickly improving symptoms. Although nivolumab was resumed after 2 months, arthritis did not recur.
Immune checkpoint inhibitors may cause a wide variety of immune-related adverse events. When arthritis is encountered during immune checkpoint inhibitor administration, seronegative rheumatoid arthritis should be differentiated from other types of arthritis, despite being less frequent.
自免疫检查点抑制剂被批准用于治疗肾细胞癌以来，治疗效果有所提高。然而，尽管可能会出现与自身免疫相关的副作用，但类风湿免疫相关不良事件很少发生。
一名78岁的日本男性肾细胞癌患者在双侧部分肾切除术后出现胰腺和肝脏转移，接受了伊匹木单抗和纳武单抗治疗。22个月后，他出现四肢和膝关节疼痛，并伴有肢体肿胀。诊断为血清阴性类风湿关节炎。停用纳武单抗，并开始使用泼尼松龙，症状迅速改善。尽管2个月后恢复使用纳武单抗，但关节炎未复发。
免疫检查点抑制剂可能会引起多种免疫相关不良事件。在使用免疫检查点抑制剂期间遇到关节炎时，尽管血清阴性类风湿关节炎不太常见，但应与其他类型的关节炎相鉴别。
