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病例报告:免疫检查点抑制剂引起的炎症性胸锁关节炎,对英夫利昔单抗有显著反应。

Case report: Inflammatory sternoclavicular joint arthritis induced by an immune checkpoint inhibitor with remarkable responsiveness to infliximab.

机构信息

Department of Rheumatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.

Department of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Kobe, Hyogo, Japan.

出版信息

Front Immunol. 2024 May 10;15:1400097. doi: 10.3389/fimmu.2024.1400097. eCollection 2024.

Abstract

This report describes the case of a 48-year-old woman who presented with sternoclavicular joint arthritis after administration of an immune checkpoint inhibitor (ICI), durvalumab, for small cell lung carcinoma. The onset of arthritis transpired 18 months after the commencement of the ICI therapeutic regimen and demonstrated resilience to glucocorticoid treatment. After excluding infectious aetiologies and metastatic involvement, the patient was diagnosed with ICI-induced arthritis (ICI-IA). Considering the articular implications akin to the SAPHO syndrome, the patient was treated with infliximab, resulting in complete resolution. This finding implies that biological DMARDs can serve as effective interventions for ICI-induced sternoclavicular joint arthritis. Given the heterogeneous nature of its pathogenesis, the selection of therapeutic agents may require customization based on the distinct clinical presentation of each individual case.

摘要

本报告描述了一例 48 岁女性在接受免疫检查点抑制剂(ICI)durvalumab 治疗小细胞肺癌后发生胸锁关节炎的病例。关节炎的发病时间是在开始 ICI 治疗方案 18 个月后,且对糖皮质激素治疗有抵抗力。在排除感染性病因和转移受累后,患者被诊断为 ICI 诱导的关节炎(ICI-IA)。考虑到关节表现类似于 SAPHO 综合征,患者接受了英夫利昔单抗治疗,结果完全缓解。这一发现意味着生物 DMARDs 可作为治疗 ICI 引起的胸锁关节关节炎的有效干预措施。鉴于其发病机制的异质性,治疗药物的选择可能需要根据每个病例的独特临床表现进行定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/deb7/11116605/39f7b9149d51/fimmu-15-1400097-g001.jpg

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