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安罗替尼显著改善了由胃癌相关的肺肿瘤血栓性微血管病(PTTM)引起的肺动脉高压和低氧血症:一例报告。

Anlotinib dramatically improved pulmonary hypertension and hypoxia caused by Pulmonary Tumor Thrombotic Microangiopathy (PTTM) associated with gastric carcinoma: a case report.

作者信息

Wang Yang, Ning Wei-Wei, Jin Yi-Fan, Zhu Qing-Qing, Wang Zai-Liang, Su Nan, Chen Yan-Bin, Huang Jian-An, Chen Cheng

机构信息

Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215000, China.

出版信息

Thromb J. 2023 Mar 27;21(1):33. doi: 10.1186/s12959-023-00477-4.

Abstract

BACKGROUND

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare malignancy-related respiratory complication, demonstrating rapid progression of pulmonary hypertension (PH) and respiratory failure. Although a number of treatments have been attempted for patients diagnosed with or suspected of having PTTM, successful-treated cases of PTTM were mainly from imatinib therapy, which was a PDGF receptor inhibitor. Anlotinib was a novel tyrosine kinase inhibitor that targets VEGFR, FGFR, PDGFR, and c-kit.

CASE PRESENTATION

We reported a patient of PTTM associated with gastric carcinoma, whom were treated with anlotinib, thereby exhibiting significant improvement of PH and respiratory dysfunction.

CONCLUSION

Our case provides a new understanding of therapy to PTTM, with implications for defining anlotinib as candidate drug for PTTM. Clinical diagnosis and prompt initiation of anlotinib might be one of the strategies in patients with unstable PTTM.

摘要

背景

肺肿瘤血栓性微血管病(PTTM)是一种罕见的与恶性肿瘤相关的呼吸系统并发症,表现为肺动脉高压(PH)和呼吸衰竭的快速进展。尽管已对诊断为或疑似患有PTTM的患者尝试了多种治疗方法,但PTTM的成功治疗病例主要来自伊马替尼治疗,伊马替尼是一种血小板衍生生长因子(PDGF)受体抑制剂。安罗替尼是一种新型酪氨酸激酶抑制剂,靶向血管内皮生长因子受体(VEGFR)、成纤维细胞生长因子受体(FGFR)、血小板衍生生长因子受体(PDGFR)和干细胞生长因子受体(c-kit)。

病例报告

我们报告了一名与胃癌相关的PTTM患者,该患者接受了安罗替尼治疗,从而使PH和呼吸功能障碍得到显著改善。

结论

我们的病例为PTTM的治疗提供了新的认识,意味着将安罗替尼定义为PTTM的候选药物。临床诊断并及时开始使用安罗替尼可能是不稳定型PTTM患者的策略之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4243/10041787/4366ec400b8b/12959_2023_477_Fig1_HTML.jpg

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