Segawa Takuya, Motoshima Takanobu, Yatsuda Junji, Kurahashi Ryoma, Fukushima Yumi, Murakami Yoji, Yamaguchi Takahiro, Sugiyama Yutaka, Yoshida Ryoji, Nakayama Hideki, Kamba Tomomi
Department of Urology Kumamoto University Kumamoto Japan.
Department of Oral and Maxillofacial Surgery Kumamoto University Kumamoto Japan.
IJU Case Rep. 2023 Jan 6;6(2):147-149. doi: 10.1002/iju5.12573. eCollection 2023 Mar.
Dry mouth is the main symptom of sicca syndrome, which rarely occurs as an immune-related adverse event. Here we report a case of sicca syndrome caused by immune checkpoint inhibitor treatment.
A 70-year-old man was diagnosed with left renal cell carcinoma after radical left nephrectomy. Nine years later, computed tomography revealed a metastatic nodule in the upper left lung lobe. Subsequently, ipilimumab and nivolumab were administered for recurrent disease. After 13 weeks of treatment, xerostomia and dysgeusia were noted. Salivary gland biopsy revealed lymphocyte and plasma cell infiltration in the salivary glands. Sicca syndrome was diagnosed and pilocarpine hydrochloride was prescribed without corticosteroids, with continuation of immune checkpoint inhibitor therapy. The symptoms alleviated after 36 weeks of treatment, with shrinkage of the metastatic lesions.
We experienced sicca syndrome caused by immune checkpoint inhibitors. Sicca syndrome improved without steroids and the immunotherapy could be continued.
口干是干燥综合征的主要症状，很少作为免疫相关不良事件出现。在此我们报告一例由免疫检查点抑制剂治疗引起的干燥综合征病例。
一名70岁男性在接受根治性左肾切除术后被诊断为左肾细胞癌。九年后，计算机断层扫描显示左上肺叶有一个转移结节。随后，给予伊匹木单抗和纳武单抗治疗复发性疾病。治疗13周后，出现口干和味觉障碍。唾液腺活检显示唾液腺中有淋巴细胞和浆细胞浸润。诊断为干燥综合征，在未使用皮质类固醇的情况下开具了盐酸毛果芸香碱，并继续进行免疫检查点抑制剂治疗。治疗36周后症状缓解，转移病灶缩小。
我们遇到了由免疫检查点抑制剂引起的干燥综合征。干燥综合征在未使用类固醇的情况下得到改善，免疫治疗可以继续。
