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双重打击：一例接受纳武单抗治疗患者出现免疫检查点抑制剂相关性结肠炎合并并存性结肠炎的病例报告

Double Whammy: A Case Report of Immune Checkpoint Inhibitor Colitis and Concomitant Colitis in a Patient on Nivolumab.

作者信息

Gautam Misha, Jahagirdar Vinay, Mahadevia Himil, Sanders Kimberly, Campbell John P, Sylvestre Pamela B, Chhabra Rajiv, Clarkston Wendell, Jonnalagadda Sreenivasa S

机构信息

Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO.

Gastroenterology and Hepatology, University of Missouri-Kansas City School of Medicine, Kansas City, MO.

出版信息

ACG Case Rep J. 2024 Dec 27;12(1):e01569. doi: 10.14309/crj.0000000000001569. eCollection 2025 Jan.

DOI:10.14309/crj.0000000000001569
PMID:39734389
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11671063/
Abstract

Immune checkpoint inhibitors commonly cause gastrointestinal immune-related adverse effects. These patients also carry an increased risk of concomitant infections. This 66-year-old man with immune checkpoint inhibitor colitis was discovered to have concurrent and colitis. Such infections may mimic or complicate disease course. Hence, clinicians must monitor patient symptoms, have a low threshold for infectious testing and colonoscopy, and consider treatment strategies to mitigate their risk.

摘要

免疫检查点抑制剂通常会引起胃肠道免疫相关不良反应。这些患者同时发生感染的风险也会增加。这位66岁患有免疫检查点抑制剂相关性结肠炎的男性被发现同时患有[此处原文缺失具体感染类型]感染和结肠炎。此类感染可能会模仿疾病病程或使病程复杂化。因此，临床医生必须监测患者症状，对进行感染检测和结肠镜检查保持较低的阈值，并考虑采取治疗策略以降低风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/1cb6465996a4/ac9-12-e01569-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/86a8023af356/ac9-12-e01569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/5d1a0686ae25/ac9-12-e01569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/1cb6465996a4/ac9-12-e01569-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/86a8023af356/ac9-12-e01569-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/5d1a0686ae25/ac9-12-e01569-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ed/11671063/1cb6465996a4/ac9-12-e01569-g003.jpg

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本文引用的文献

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Ustekinumab for Refractory Colitis Associated with Immune Checkpoint Inhibitors.优特克单抗用于治疗与免疫检查点抑制剂相关的难治性结肠炎。
N Engl J Med. 2021 Feb 11;384(6):581-583. doi: 10.1056/NEJMc2031717.
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Fecal calprotectin concentration to assess endoscopic and histologic remission in patients with cancer with immune-mediated diarrhea and colitis.检测粪便钙卫蛋白浓度评估免疫介导性腹泻和结肠炎相关癌症患者的内镜和组织学缓解情况。
J Immunother Cancer. 2021 Jan;9(1). doi: 10.1136/jitc-2020-002058.
3
Efficacy and Outcome of Tofacitinib in Immune checkpoint Inhibitor Colitis.
托法替布在免疫检查点抑制剂所致结肠炎中的疗效与结局
Gastroenterology. 2021 Feb;160(3):932-934.e3. doi: 10.1053/j.gastro.2020.10.029. Epub 2020 Oct 21.
4
AGA Clinical Practice Update on Diagnosis and Management of Immune Checkpoint Inhibitor Colitis and Hepatitis: Expert Review.AGA 临床实践更新：免疫检查点抑制剂相关性结肠炎和肝炎的诊断与管理：专家综述。
Gastroenterology. 2021 Mar;160(4):1384-1393. doi: 10.1053/j.gastro.2020.08.063. Epub 2020 Oct 17.
5
Vitamin D intake is associated with decreased risk of immune checkpoint inhibitor-induced colitis.维生素 D 摄入与免疫检查点抑制剂诱导的结肠炎风险降低有关。
Cancer. 2020 Aug 15;126(16):3758-3767. doi: 10.1002/cncr.32966. Epub 2020 Jun 22.
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Leucine-Rich α-Glycoprotein as a Potential Biomarker for Immune-related Colitis After Anti-PD-L1 Therapy: A Report of a Case Series.富含亮氨酸的α-糖蛋白作为抗PD-L1治疗后免疫相关性结肠炎的潜在生物标志物：病例系列报告
Clin Lung Cancer. 2020 Nov;21(6):e516-e522. doi: 10.1016/j.cllc.2020.04.005. Epub 2020 Apr 13.
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