Suzuki Toshio
Department of Medical Oncology, University of Tsukuba, Tsukuba, JPN.
Cureus. 2023 Dec 10;15(12):e50272. doi: 10.7759/cureus.50272. eCollection 2023 Dec.
Confirmation bias can impede accurate diagnosis. Since the approval of immune checkpoint inhibitors (ICIs), physicians are on high alert for newly developed immune-related adverse events (irAEs). Therefore, when patients present irAE-like symptoms, there is a risk of confirmation bias leading to overlooked diagnoses. This paper discusses a case of a patient with non-small cell lung cancer treated with nivolumab and topical dexamethasone ointment for an extended period due to oral mucocutaneous irAE. The patient developed adrenal insufficiency, initially considered to be a likely case of pituitary irAE. However, further investigation and the patient's clinical course revealed an unexpected diagnosis more in line with topical steroid withdrawal syndrome.
确认偏误可能会妨碍准确的诊断。自从免疫检查点抑制剂（ICI）获批以来，医生们对新出现的免疫相关不良事件（irAE）保持高度警惕。因此，当患者出现类似irAE的症状时，存在确认偏误导致漏诊的风险。本文讨论了一例非小细胞肺癌患者的病例，该患者因口腔黏膜皮肤irAE长期接受纳武单抗和外用糖皮质激素软膏治疗。患者出现肾上腺功能不全，最初被认为很可能是垂体irAE。然而，进一步的检查和患者的临床病程显示，意外诊断结果更符合外用类固醇撤药综合征。
