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度伐利尤单抗引起的肌肉无力、肌炎和硬皮病。

Muscle weakness, myositis and scleroderma induced by durvalumab.

作者信息

Aguado Suquia Josu, Carballosa de Miguel Pilar, Naya Prieto Alba, Lobo Rebollo Maria Jesus, Blázquez Sánchez Teresa, Heili Frades Sarah Béatrice

机构信息

Department of Pneumology Hospital Universitario de Burgos Burgos Spain.

Department of Pneumology Hospital Universitario Fundación Jiménez Díaz Madrid Spain.

出版信息

Respirol Case Rep. 2024 Dec 6;12(12):e70084. doi: 10.1002/rcr2.70084. eCollection 2024 Dec.

DOI:10.1002/rcr2.70084
PMID:39649428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11623978/
Abstract

Immune checkpoint inhibitors (ICI) have shown a change in the prognosis of multiple malignancies, but a wide range of immune-related adverse events (irAE) can occur. We present a case of a 72-year-old Caucasian male treated with Durvalumab for epidermic lung cancer, who developed a sclerosis-like syndrome and myositis. The patient was admitted to our hospital with respiratory failure due to muscular weakness and pulmonary hypertension. Differential diagnoses pointed to scleroderma secondary to ICI. We report a rare case of ICI-induced axonal polyneuropathy, myopathy and RNA polymerase III positive scleroderma. As this therapy is widely recommended, adverse effects may become more frequent. Early identification and treatment are warranted.

摘要

免疫检查点抑制剂(ICI)已使多种恶性肿瘤的预后发生改变,但可能会出现广泛的免疫相关不良事件(irAE)。我们报告一例72岁的白种男性,因表皮样肺癌接受度伐利尤单抗治疗,出现了硬化样综合征和肌炎。该患者因肌肉无力和肺动脉高压导致呼吸衰竭入住我院。鉴别诊断指向ICI继发的硬皮病。我们报告了一例罕见的ICI诱发的轴索性多发性神经病、肌病和RNA聚合酶III阳性硬皮病。由于这种治疗方法被广泛推荐,不良反应可能会更频繁出现。因此有必要进行早期识别和治疗。

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Respirol Case Rep. 2024 Dec 6;12(12):e70084. doi: 10.1002/rcr2.70084. eCollection 2024 Dec.
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本文引用的文献

1
Systemic sclerosis and inflammatory myopathy after treatment with durvalumab in a patient with rectal neoplasm.
Clin Exp Rheumatol. 2024 Aug;42(8):1704-1705. doi: 10.55563/clinexprheumatol/qomycv. Epub 2024 Jul 26.
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Checkpoint Inhibitor-Associated Scleroderma and Scleroderma Mimics.检查点抑制剂相关的硬皮病及硬皮病样疾病
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J Med Case Rep. 2021 May 31;15(1):278. doi: 10.1186/s13256-021-02858-7.
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Immune checkpoint inhibitor-induced musculoskeletal manifestations.免疫检查点抑制剂引起的肌肉骨骼表现。
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EULAR points to consider for the diagnosis and management of rheumatic immune-related adverse events due to cancer immunotherapy with checkpoint inhibitors.EULAR 针对癌症免疫治疗中使用检查点抑制剂引起的风湿免疫相关不良事件的诊断和管理的考虑要点。
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Coexisting myasthenia gravis, myositis, and polyneuropathy induced by ipilimumab and nivolumab in a patient with non-small-cell lung cancer: A case report and literature review.一名非小细胞肺癌患者中由伊匹木单抗和纳武单抗诱发的重症肌无力、肌炎和多发性神经病并存:病例报告及文献综述
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9
Progressive hypoventilation due to mixed CD8 and CD4 lymphocytic polymyositis following tremelimumab - durvalumab treatment.进展性低通气与混合性 CD8 和 CD4 淋巴细胞性多发性肌炎有关,其发生于替西木单抗-度伐利尤单抗治疗之后。
J Immunother Cancer. 2017 Jul 18;5(1):54. doi: 10.1186/s40425-017-0258-x.
10
Association of anti-RNA polymerase III autoantibodies and cancer in scleroderma.硬皮病中抗RNA聚合酶III自身抗体与癌症的关联。
Arthritis Res Ther. 2014 Feb 14;16(1):R53. doi: 10.1186/ar4486.