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帕博利珠单抗治疗转移性肺癌患者时发生的肺动脉高压：该归咎于谁？

Pulmonary Arterial Hypertension in a Patient With Metastatic Lung Cancer on Pembrolizumab: Whom to Blame?

作者信息

Chintalacheruvu Lakshmi Manogna, Chilluru Vamsi Krishna, Gutta Narendra Babu

机构信息

Department of Hematology/Oncology, Southern Illinois Health Cancer Institute, Carterville, IL, USA.

Department of Nephrology, Southern Illinois Health, Carbondale, IL, USA.

出版信息

J Med Cases. 2025 Apr;16(4):153-157. doi: 10.14740/jmc5115. Epub 2025 Apr 26.

DOI:10.14740/jmc5115
PMID:40322626
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12045750/
Abstract

Immune checkpoint inhibitors (ICIs) play a major role in current cancer treatments. They are associated with immune-mediated side effects due to immune dysregulation. ICI-mediated complications are more commonly known to affect thyroid gland, gastrointestinal system, skin, etc. Pulmonary arterial hypertension (PAH) due to ICIs is not very well described in the literature. Here, we report a case of severe PAH diagnosed in a patient with metastatic lung cancer on long-term pembrolizumab and literature review.

摘要

免疫检查点抑制剂（ICIs）在当前癌症治疗中发挥着重要作用。由于免疫失调，它们与免疫介导的副作用相关。ICI介导的并发症更常见于影响甲状腺、胃肠道系统、皮肤等。ICI导致的肺动脉高压（PAH）在文献中描述得并不多。在此，我们报告一例在接受长期派姆单抗治疗的转移性肺癌患者中诊断出的严重PAH病例，并进行文献综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c358/12045750/58930360090e/jmc-16-04-153-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c358/12045750/e327c0beb4d5/jmc-16-04-153-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c358/12045750/58930360090e/jmc-16-04-153-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c358/12045750/e327c0beb4d5/jmc-16-04-153-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c358/12045750/58930360090e/jmc-16-04-153-g002.jpg

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本文引用的文献

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Cancer Therapy-Associated Pulmonary Hypertension and Right Ventricular Dysfunction: Etiologies and Prognostic Implications.癌症治疗相关的肺动脉高压和右心室功能障碍：病因及预后意义
Rev Cardiovasc Med. 2024 Mar 5;25(3):87. doi: 10.31083/j.rcm2503087. eCollection 2024 Mar.
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The role of immune cells and inflammation in pulmonary hypertension: mechanisms and implications.免疫细胞和炎症在肺动脉高压中的作用：机制与意义。
Front Immunol. 2024 Mar 11;15:1374506. doi: 10.3389/fimmu.2024.1374506. eCollection 2024.
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The Role and Mechanism of Gut Microbiota in Pulmonary Arterial Hypertension.
肠道微生物群在肺动脉高压中的作用和机制。
Nutrients. 2022 Oct 13;14(20):4278. doi: 10.3390/nu14204278.
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Cancer Immunol Immunother. 2022 Dec;71(12):3093-3097. doi: 10.1007/s00262-022-03208-2. Epub 2022 May 26.
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2021 American Thoracic Society BEAR Cage Winning Proposal: Microbiome Transplant in Pulmonary Arterial Hypertension.2021年美国胸科学会熊笼奖获奖提案：肺动脉高压中的微生物群移植
Am J Respir Crit Care Med. 2022 Jan 1;205(1):13-16. doi: 10.1164/rccm.202108-1833ED.
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Biomaterials. 2021 Sep;276:121058. doi: 10.1016/j.biomaterials.2021.121058. Epub 2021 Aug 5.
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