首页|免疫检查点抑制剂治疗导致相关垂体炎1例并文献复习

免疫检查点抑制剂治疗导致相关垂体炎1例并文献复习

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免疫检查点抑制剂(immune check piont inhibitors,ICPis)通过阻断免疫抑制分子,重新激活效应T细胞特异性杀伤肿瘤细胞的功能,发挥抗肿瘤作用.本文报道1例程序性死亡受体1(programmeddeath-1,PD-1)抑制剂相关垂体炎导致的继发性肾上腺皮质功能减退的患者.该患者为65岁男性,因右肺鳞癌侵犯胸壁(cT4N2M0),接受免疫治疗4次,末次免疫治疗后2周出现纳差、乏力,检查结果提示重度低钠血症,并在反复补充高浓度氯化钠治疗后无改善.进一步完善检查后予糖皮质激素补充治疗,患者临床症状及生化指标均显著改善.对于接受ICPis治疗的患者,建议在起始治疗前详细询问病史,合理开展基线筛查,并在用药后定期随访内分泌激素水平及相关生化指标.同时,关注患者可能出现的相关症状、体征,以便及时发现内分泌腺体相关不良反应.
Hypophysitis associated with immune check piont inhibitors treatment:A case report and literature review
Immune checkpoint inhibitors(ICPis)significantly improves survival in a number of cancer patients by blocking immunosuppressive molecules and reactivating the function of effector T cells to specifically kil tumor cells.This article reports a case of secondary hypoadrenocorticism caused by programmed death 1(PD-1)inhibitor related hypophysitis.A 65-year-old male patient received immunotherapy for right lung squamous cell carcinoma invading the chest wall(cT4N2MO)for 4 times.Two weeks after the last immunotherapy treatment,the patient experienced poor appetite and fatigue.Examination results indicated severe hyponatremia,and there was no improvement even after repeated supplementation with high-concentration sodium chloride.After further examination,glucocorticoid supplementation was given to the patient and his clinical symptoms were significantly improved.It is recommended that patients receiving ICPis should be asked in detail about their medical history before initiating treatment,baseline screening should be carried out reasonably,and regular follow-up about endocrine gland hormone and related biochemical indexes after treatment should be carried out.Meanwhile,it is necessary to pay attention to the related symptoms and signs of patients in order to find endocrine gland adverse reactions in time.

immune check piont inhibitorsprogrammed death 1 inhibitorsecondary hypoadrenocorticism

魏婕、韩星星、叶禹彤、齐田田、周添燕、陆峰、颜新林、鹿斌

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昆山市中西医结合医院内分泌科,江苏苏州 215000

复旦大学附属华东医院内分泌科,上海 200040

免疫检查点抑制剂 程序性死亡受体1抑制剂 继发性肾上腺皮质功能减退

2024

中南大学学报(医学版)
中南大学

中南大学学报(医学版)

CSTPCD北大核心
影响因子:1.459
ISSN:1672-7347
年,卷(期):2024.49(7)