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CMV 合并感染治疗难治性免疫检查点抑制剂结肠炎。

CMV coinfection in treatment refractory immune checkpoint inhibitor colitis.

机构信息

Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA

Department of Hematology and Oncology, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

出版信息

BMJ Case Rep. 2020 May 19;13(5):e233519. doi: 10.1136/bcr-2019-233519.

Abstract

As immune checkpoint inhibitors (ICIs) are increasingly used, clinicians are more frequently encountering the side effects of these therapies. ICIs have been implicated in numerous adverse effects against healthy tissues. We present a case of a patient who developed treatment refractory checkpoint inhibitor colitis. Following colonoscopy, it was discovered that this patient had cytomegalovirus (CMV) coinfection. This case report highlights the importance of undertaking an appropriate assessment, including endoscopic and histologic investigation, of patients with presumed ICI colitis. Accurately diagnosing a superimposed CMV colitis changes clinical management and can improve patient outcomes.

摘要

随着免疫检查点抑制剂(ICIs)的应用越来越广泛,临床医生越来越多地遇到这些治疗方法的副作用。ICIs 与许多针对健康组织的不良反应有关。我们报告了一例发生治疗抵抗性检查点抑制剂结肠炎的患者。结肠镜检查后发现该患者合并巨细胞病毒(CMV)感染。本病例报告强调了对疑似 ICI 结肠炎患者进行适当评估的重要性,包括内镜和组织学检查。准确诊断并发的 CMV 结肠炎可改变临床治疗方法,改善患者结局。

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