Li Shishi, Zheng Ke, Xu Yan, Wang Mengzhao
Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Respiratory and Critical Care Medicine, Liuyang Hospital of Chinese Medicine, Changsha 410300, China.
Zhongguo Fei Ai Za Zhi. 2023 Sep 20;26(9):709-716. doi: 10.3779/j.issn.1009-3419.2023.106.17.
A patient with advanced lung adenocarcinoma developed symptoms of frequent urination and urgent urination after 14 cycles of Pembrolizumab combined with chemotherapy. After making comprehensive analysis of the results of urine routine test, renal function, cystoscope and computed tomography (CT) examination, immune checkpoint inhibitors related cystoureteritis and acute kidney injury were considered. The patient's symptoms were relieved after discontinuation of Pembrolizumab combined with chemotherapy. However, the symptoms of urinary irritation worsened significantly after rechallenging Pembrolizumab combined with chemotherapy, and the symptoms was relieved after corticosteroids treatment. If patients develop urinary symptoms during immune checkpoint inhibitors treatment, immune checkpoint inhibitors related cystoureteritis should be considered for early differential diagnosis in order to implement appropriate treatment. .
一名晚期肺腺癌患者在接受帕博利珠单抗联合化疗14个周期后出现尿频、尿急症状。综合分析尿常规、肾功能、膀胱镜及计算机断层扫描（CT）检查结果后，考虑为免疫检查点抑制剂相关的膀胱输尿管炎和急性肾损伤。停用帕博利珠单抗联合化疗后患者症状缓解。然而，再次使用帕博利珠单抗联合化疗后尿路刺激症状明显加重，经糖皮质激素治疗后症状缓解。免疫检查点抑制剂治疗期间若患者出现泌尿系统症状，应考虑早期鉴别诊断免疫检查点抑制剂相关的膀胱输尿管炎，以便实施恰当治疗。
