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帕博利珠单抗相关的史蒂文斯-约翰逊综合征在一名转移性非小细胞肺癌患者中的病例报告

Pembrolizumab-Associated Stevens-Johnson Syndrome in a Patient With Metastatic Non-small Cell Lung Cancer: A Case Report.

作者信息

Sandhu Michael, Kc Binod, Bhandari Jenish, Gambhir Harvir S, Farah Ramsay

机构信息

Department of Medicine, Upstate University Hospital, Syracuse, USA.

Department of Dermatology, Upstate University Hospital, Syracuse, USA.

出版信息

Cureus. 2023 Jul 6;15(7):e41439. doi: 10.7759/cureus.41439. eCollection 2023 Jul.

Abstract

Pembrolizumab is a monoclonal antibody that binds to the programmed cell death-1 (PD-1) receptor and is approved for the treatment of several malignancies. We present a rare case of Stevens-Johnson syndrome (SJS) occurring in a 75-year-old female 14 days after receiving the first dose of pembrolizumab therapy to treat stage IV non-small cell carcinoma of the lungs with metastasis to the brain. Although pruritus and papular, erythematous rashes are documented after its use, severe reactions such as SJS and toxic epidermal necrolysis (TEN) are rarely seen in clinical practice. In addition to supportive care, the patient also received intravenous immunoglobulin (IVIG) and corticosteroid therapy and responded well to the therapy. Nearly complete re-epithelialization was achieved four weeks after the start of skin lesions. This case highlights a rare phenomenon of SJS- and TEN-associated adverse reactions following treatment with pembrolizumab.

摘要

帕博利珠单抗是一种单克隆抗体,可与程序性细胞死亡蛋白1(PD-1)受体结合,已被批准用于治疗多种恶性肿瘤。我们报告了一例罕见的史蒂文斯-约翰逊综合征(SJS)病例,该病例发生在一名75岁女性身上,她在接受第一剂帕博利珠单抗治疗以治疗伴有脑转移的IV期非小细胞肺癌14天后出现了SJS。尽管在使用帕博利珠单抗后有瘙痒和丘疹、红斑皮疹的记录,但在临床实践中很少见到如SJS和中毒性表皮坏死松解症(TEN)等严重反应。除了支持性治疗外,患者还接受了静脉注射免疫球蛋白(IVIG)和皮质类固醇治疗,对治疗反应良好。皮肤病变开始四周后实现了几乎完全的上皮再形成。该病例突出了帕博利珠单抗治疗后出现SJS和TEN相关不良反应的罕见现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8690/10403812/b3cf2ed672d3/cureus-0015-00000041439-i01.jpg

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