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抗程序性死亡-1 抗体治疗过程中出现 Vogt-Koyanagi-Harada 病样葡萄膜炎:病例报告。

Development of Vogt-Koyanagi-Harada disease-like uveitis during treatment by anti-programmed death-1 antibody: a case report.

机构信息

Department of Ophthalmology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.

Peking University Fifth School of Clinical Medicine, Beijing, China.

出版信息

BMC Ophthalmol. 2024 Jun 7;24(1):240. doi: 10.1186/s12886-024-03484-9.

Abstract

BACKGROUND

Several immune checkpoint inhibitors (ICIs) have been linked to the occurrence of Vogt-Koyanagi-Harada disease (VKHD)-like uveitis. Among the ICIs, there has been no report of immune-related adverse events (irAEs) caused by a new programmed death protein-1(PD-1) monoclonal antibody (Toripalimab).

CASE PRESENTATION

This paper presents a case of VKHD-like uveitis that arose following Toripalimab therapy for urothelial cancer of the bladder, and the patient experienced symptoms 10 days after the final dosage of 20 months of medication treatment. This patient with bladder uroepithelial carcinoma had severe binocular acute panuveitis with exudative retinal detachment after receiving Toripalimab therapy. Binocular VKHD-like uveitis was suggested as a diagnosis. Both eyes recovered after discontinuing immune checkpoint inhibitors and local and systemic corticosteroid treatment.

CONCLUSIONS

This report suggests that VKHD-like uveitis can also occur in patients receiving novel PD-1 antibodies and the importance of paying attention to eye complications in patients receiving treatment over a long period.

摘要

背景

几种免疫检查点抑制剂(ICIs)已被发现与 Vogt-Koyanagi-Harada 病(VKHD)样葡萄膜炎有关。在这些 ICI 中,尚未有报告称新型程序性死亡蛋白-1(PD-1)单克隆抗体(特瑞普利单抗)引起免疫相关不良事件(irAEs)。

病例介绍

本文报告了一例膀胱癌接受特瑞普利单抗治疗后发生 VKHD 样葡萄膜炎的病例,该患者在 20 个月疗程的最后一次用药后 10 天出现症状。这位患有膀胱尿路上皮癌的患者在接受特瑞普利单抗治疗后出现严重双眼急性全葡萄膜炎伴渗出性视网膜脱离。诊断为双眼 VKHD 样葡萄膜炎。停用免疫检查点抑制剂和局部及全身皮质类固醇治疗后,双眼恢复。

结论

本报告提示新型 PD-1 抗体治疗也可引起 VKHD 样葡萄膜炎,提示在长期治疗过程中应注意患者眼部并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2346/11157912/7fa77a6f98c4/12886_2024_3484_Fig1_HTML.jpg

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