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病例报告:一名胃癌患者发生信迪利单抗诱导的皮肌炎的罕见病例。

Case Report: A rare case of sintilimab-induced dermatomyositis in a patient with gastric cancer.

作者信息

Mou Peipei, Li Fanghua, Wang Yingying, Zhao Feifei

机构信息

Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, Shandong, China.

Department of Oncology, Shengli Oilfield Central Hospital, Dongying, Shandong, China.

出版信息

Front Oncol. 2025 Apr 16;15:1517391. doi: 10.3389/fonc.2025.1517391. eCollection 2025.

Abstract

The PD-1 inhibitor sintilimab has been approved for the treatment of various malignancies. Here, we reported a rare case of sintilimab-induced dermatomyositis in a patient with gastric cancer and liver metastasis to raise awareness of this serious adverse event. A 64-year-old man presented with the onset of gastric cancer and liver metastasis and received two cycles of sintilimab plus nab-paclitaxel. The patient experienced fever, thrombocytopenia, and rash during the first-cycle treatment, followed by bilateral ptosis, dysphagia, slurred speech, and myalgia during the second-cycle treatment. Elevated muscle enzymes, electromyography, and positive myositis antibodies confirmed the diagnosis of dermatomyositis. He was treated with high-dose corticosteroids and immunoglobulin, resulting in symptom improvement. This case widens the spectrum of immune-related toxicity associated with sintilimab, as well as highlights the need for early recognition and management of these events in patients receiving ICIs.

摘要

程序性死亡受体 1(PD-1)抑制剂信迪利单抗已被批准用于治疗多种恶性肿瘤。在此,我们报告了1例罕见的信迪利单抗诱发的皮肌炎病例,该患者患有胃癌并伴有肝转移,旨在提高对这一严重不良事件的认识。一名64岁男性因胃癌伴肝转移就诊,接受了2个周期的信迪利单抗联合白蛋白结合型紫杉醇治疗。患者在第1周期治疗期间出现发热、血小板减少和皮疹,在第2周期治疗期间出现双侧上睑下垂、吞咽困难、言语不清和肌痛。肌酶升高、肌电图检查及肌炎抗体阳性确诊为皮肌炎。患者接受大剂量糖皮质激素和免疫球蛋白治疗后症状改善。该病例拓宽了信迪利单抗相关免疫相关毒性的范围,同时也凸显了在接受免疫检查点抑制剂(ICI)治疗的患者中早期识别和处理这些事件的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c8/12040691/ed34421b0862/fonc-15-1517391-g001.jpg

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