Qi Rongbin, Xu Hailing, Fu Xinyu, Yu Yingying, Lv Dongqing, Li Yujing, He Susu
Department of Respiratory Medicine, TaiZhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.
Department of Gastroenterology, Taizhou Hospital, Wenzhou Medical University, Linhai, Zhejiang, China.
Front Oncol. 2023 Aug 1;13:1046266. doi: 10.3389/fonc.2023.1046266. eCollection 2023.
Immune-related adverse reactions primarily involve the skin and the endocrine, digestive, and respiratory systems. In the endocrine system, these adverse effects mainly include hypophysitis, thyroiditis, hypoadrenalism, and rarely, diabetes mellitus. The most common symptoms in the skin are pruritus, rash, and infrequently, eruptive keratoacanthoma. Here, we report a case of a 67-year-old woman who developed eruptive keratoacanthoma of the skin 6 weeks after beginning treatment with a bispecific antibody (PM8001), targeting both programmed cell death receptor 1 and transforming growth factor β, as well as type I diabetes mellitus-induced ketoacidosis after 13 weeks. The type I diabetes appeared to stabilize after insulin treatment, and the keratoacanthoma gradually resolved after drug discontinuation. This case report describes a case of the effects of PM8001 immunotherapy on the endocrine glands and skin, together with a review of the relevant literature, and summarizes the different clinical characteristics of rare immune-related adverse events resulting from PM8001 immunotherapy to provide a reference for their early detection, diagnosis, and treatment.
免疫相关不良反应主要累及皮肤以及内分泌、消化和呼吸系统。在内分泌系统中，这些不良反应主要包括垂体炎、甲状腺炎、肾上腺功能减退，很少见的还有糖尿病。皮肤最常见的症状是瘙痒、皮疹，偶尔还有爆发性角化棘皮瘤。在此，我们报告一例67岁女性病例，该患者在开始使用一种同时靶向程序性细胞死亡受体1和转化生长因子β的双特异性抗体（PM8001）治疗6周后出现皮肤爆发性角化棘皮瘤，并在13周后出现1型糖尿病诱发的酮症酸中毒。1型糖尿病在胰岛素治疗后似乎趋于稳定，角化棘皮瘤在停药后逐渐消退。本病例报告描述了PM8001免疫治疗对内分泌腺和皮肤的影响病例，并对相关文献进行了综述，总结了PM8001免疫治疗导致的罕见免疫相关不良事件的不同临床特征，为其早期发现、诊断和治疗提供参考。
