Xu Ruo-Wen, Dong Wen-Bo, Wang Yong-Xu, Liu Yong-Qi, Chen Chen, Wang Wei, Liu Hai-Na, Jin Hong-Yu, Li Wen-Yang
Respiratory and Critical Care Department, The First Hospital of China Medical University, Shenyang, China.
First Clinical College, China Medical University, Shenyang, China.
Front Immunol. 2025 Aug 14;16:1619229. doi: 10.3389/fimmu.2025.1619229. eCollection 2025.
Up to 22% of cancer patients treated with immune checkpoint inhibitors (ICIs) can experience immune-related adverse events (irAEs) that mimic rheumatic disease, such as relapsing polychondritis (RP), which is a rare autoimmune disease that mainly manifests as inflammation of airway cartilage.
We report a case of RP induced by humanized recombinant anti-PD-1 monoclonal antibody therapy (tislelizumab). 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) contributed to the diagnosis of RP, and methylprednisolone was used to effectively control its progression. We also reviewed 13 publications on drug-induced RP in the context of cancer and analyzed the pathogenesis, ancillary tests, treatment, and prognosis of the cases described therein.
Including our case, 14 drug-related RP cases with a tumor background were analyzed. Patients usually develop related symptoms 3-5 months after initiating medication. The primary tumor involvement sites included the hematological system (5/14, 35.71%), upper digestive tract (4/14, 28.57%), skin (2/14, 14.29%), reproductive system (2/14, 14.29%), bone (1/14,7.14%), and lung (1/ 14, 7.14%).
18F-FDG PET/CT plays a crucial role in diagnosing RP caused by PD-1 monoclonal antibodies. Early detection and the prompt administration of corticosteroids are crucial in effectively controlling the progression of RP, helping to alleviate symptoms and prevent further complications.
接受免疫检查点抑制剂（ICI）治疗的癌症患者中，高达22%会出现类似风湿性疾病的免疫相关不良事件（irAE），如复发性多软骨炎（RP），这是一种罕见的自身免疫性疾病，主要表现为气道软骨炎症。
我们报告一例由人源化重组抗PD-1单克隆抗体疗法（替雷利珠单抗）诱发的RP病例。18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）有助于RP的诊断，甲基强的松龙可有效控制其进展。我们还回顾了13篇关于癌症背景下药物性RP的文献，并分析了其中所述病例的发病机制、辅助检查、治疗及预后。
包括我们的病例在内，共分析了14例有肿瘤背景的药物相关性RP病例。患者通常在开始用药后3 - 5个月出现相关症状。原发性肿瘤累及部位包括血液系统（5/14，35.71%）、上消化道（4/14，28.57%）、皮肤（2/14，14.29%）、生殖系统（2/14，14.29%）、骨骼（1/14，7.14%）和肺部（1/14，7.14%）。
18F-FDG PET/CT在诊断由PD-1单克隆抗体引起的RP中起关键作用。早期发现并及时给予皮质类固醇对于有效控制RP的进展、缓解症状及预防进一步并发症至关重要。
