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免疫检查点抑制剂诱发的结肠炎,需保持警惕:一例病例报告

Immune checkpoint inhibitors induced colitis, stay vigilant: A case report.

作者信息

Abu Khalaf Suha, Albarrak Abdulmajeed, Yousef Mohamad, Tahan Veysel

机构信息

Department of Internal Medicine, University of Missouri, Columbia, MO 65212, United States.

Department of Internal Medicine, College of Medicine, Qassim University, Buraydah 81999, Saudi Arabia.

出版信息

World J Gastrointest Oncol. 2020 Jun 15;12(6):699-704. doi: 10.4251/wjgo.v12.i6.699.

Abstract

BACKGROUND

Colitis is one of the immune-related side effects of immunotherapy. Usually, such type of side effect was reported to develop within a few weeks of treatment initiation, our case started within a few days.

CASE SUMMARY

We present a case of a 37-year-old gentleman with bright red loose stools, abdominal pain, and tenesmus. A diagnosis of colitis was made based on endoscopic and histologic findings. Treatment was thereafter continued with oral steroids and discontinuation of the immunotherapy medications. Symptoms resolved after starting the treatment and the patient continued to be symptom-free on subsequent follow-up. The unique about this case report is that the patient developed bloody diarrhea within five days of the 1 immunotherapy cycle, and the patient was on combined ipilimumab and nivolumab.

CONCLUSION

Immunotherapy related complications might occur within days from being on immunotherapy; we need more research to open the way for future pathological and clinical research to further understand the pathophysiology behind it.

摘要

背景

结肠炎是免疫治疗的免疫相关副作用之一。通常,这类副作用据报道在治疗开始后的几周内出现,而我们的病例在几天内就开始了。

病例摘要

我们报告一例37岁男性患者,有鲜红色稀便、腹痛和里急后重症状。根据内镜和组织学检查结果诊断为结肠炎。此后继续口服类固醇治疗并停用免疫治疗药物。治疗开始后症状缓解,患者在随后的随访中一直无症状。本病例报告的独特之处在于,患者在免疫治疗第1周期的5天内出现血性腹泻,且患者同时使用了伊匹木单抗和纳武单抗。

结论

免疫治疗相关并发症可能在免疫治疗开始后的数天内发生;我们需要更多研究为未来的病理学和临床研究开辟道路,以进一步了解其背后的病理生理学机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bce2/7340999/7a22855070cf/WJGO-12-699-g001.jpg

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