病例报告:替雷利珠单抗诱导食管鳞状细胞癌患者发生中毒性表皮坏死松解症。
Case report: Toxic epidermal necrolysis induced by tislelizumab in a patient with esophageal squamous cell carcinoma.
作者信息
Wu Shilong, Xu Chenyang, Liu Huafeng
机构信息
Department of Thoracic Surgery, Ganzhou People's Hospital, Ganzhou, China.
Department of Oncology, Ganzhou People's Hospital, Ganzhou, China.
出版信息
Front Med (Lausanne). 2024 Dec 23;11:1522525. doi: 10.3389/fmed.2024.1522525. eCollection 2024.
BACKGROUND
Immune checkpoint inhibitors (ICIs) have been widely applicated for the treatment of patients with advanced esophageal cancer. Skin-related adverse reactions are frequent with ICIs, with toxic epidermal necrolysis (TEN) being a severe and potentially life-threatening cutaneous reaction.
CASE PRESENTATION
We present a case of a 70-year-old male with locally advanced esophageal cancer who developed severe toxic epidermal necrolysis (TEN) after 18 days of tislelizumab combined with chemotherapy. The condition rapidly progressed to cover approximately 90% of his body. After treatment with intravenous methylprednisolone, immunoglobulin, and antibiotics, along with active nutritional support and wound care, the patient recovered from TEN induced by tislelizumab.
CONCLUSION
Treatment for TEN is complex, and no standardized guidelines currently exist. We propose an economical, safe, effective, and simple strategy for similar TEN patients.
背景
免疫检查点抑制剂(ICIs)已广泛应用于晚期食管癌患者的治疗。ICIs常引发皮肤相关不良反应,中毒性表皮坏死松解症(TEN)是一种严重且可能危及生命的皮肤反应。
病例报告
我们报告一例70岁局部晚期食管癌男性患者,在替雷利珠单抗联合化疗18天后发生严重中毒性表皮坏死松解症(TEN)。病情迅速进展,累及身体约90%的面积。经静脉注射甲泼尼龙、免疫球蛋白和抗生素治疗,同时给予积极的营养支持和伤口护理后,该患者从替雷利珠单抗诱导的TEN中康复。
结论
TEN的治疗较为复杂,目前尚无标准化指南。我们为类似的TEN患者提出了一种经济、安全、有效且简单的治疗策略。
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本文引用的文献
World J Gastroenterol. 2024-5-21
Ann Thorac Surg. 2024-7
Front Med (Lausanne). 2023-10-11