The Department of SICU, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, 310003, China.
Immunotherapy. 2023 Aug;15(12):897-903. doi: 10.2217/imt-2023-0030. Epub 2023 Jun 20.
Herein, we report a case of an elderly male patient who underwent extended radical resection of cardiac carcinoma after regular chemotherapy combined with sintilimab (PD-1 monoclonal antibody) immunotherapy complicated with severe pneumonitis postoperatively. We performed several treatments for aspiration pneumonitis; however, the patient's pulmonary infection and oxygenation were not efficiently improved. The multidisciplinary team considered it an immune checkpoint inhibitor-associated pneumonitis after diagnosis and treatment and then modified the treatment regimen. The pulmonary inflammation was effectively controlled with improved oxygenation; the patient was gradually weaned from the ventilator and finally discharged. The possibility of immune checkpoint inhibitor-associated pneumonitis should be fully considered particularly for patients with a history of immunosuppressive therapy with clinical symptoms of severe pneumonitis.
在此,我们报告一例老年男性患者,在接受常规化疗联合信迪利单抗(PD-1 单克隆抗体)免疫治疗后,行心脏癌扩大根治术,术后并发严重肺炎。我们对吸入性肺炎进行了多次治疗,但患者的肺部感染和氧合情况并未得到有效改善。多学科团队在诊断和治疗后考虑为免疫检查点抑制剂相关肺炎,并修改了治疗方案。通过改善氧合,肺部炎症得到有效控制;患者逐渐脱离呼吸机,最终出院。对于有免疫抑制治疗史且有严重肺炎临床症状的患者,应充分考虑免疫检查点抑制剂相关肺炎的可能性。