Ono Yoya, Kunieda Kenjiro, Ohno Tomohisa, Fujishima Ichiro, Shimohata Takayoshi
Department of Neurology, Gifu University Graduate School of Medicine, Japan.
Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Japan.
Intern Med. 2025 Jul 1;64(13):2068-2072. doi: 10.2169/internalmedicine.4254-24. Epub 2024 Dec 26.
A 69-year-old woman with left-sided breast cancer developed elevated creatine kinase levels and muscle weakness in her extremities after treatment with pembrolizumab. The patient was diagnosed with immune checkpoint inhibitor (ICI)-related myositis. Although the patient had no symptoms of dysphagia, we evaluated her swallowing function because esophageal dysfunction is a known complication of idiopathic inflammatory myopathy. A videofluoroscopic swallowing study detected barium residues in the lower esophagus. Furthermore, high-resolution manometry showed impaired upper esophageal sphincter opening and absence of esophageal peristalsis, which improved partially after immunotherapy. These findings suggest that esophageal dysfunction may be an unrecognized complication of ICI-related myositis.
一名69岁的左侧乳腺癌女性在接受派姆单抗治疗后出现肌酸激酶水平升高及四肢肌肉无力。该患者被诊断为免疫检查点抑制剂（ICI）相关的肌炎。尽管患者没有吞咽困难症状，但由于食管功能障碍是特发性炎性肌病的已知并发症，我们对她的吞咽功能进行了评估。电视荧光吞咽造影检查发现食管下段有钡剂残留。此外，高分辨率测压显示食管上括约肌开放受损且食管无蠕动，免疫治疗后部分改善。这些发现提示食管功能障碍可能是ICI相关肌炎一种未被认识到的并发症。
