Toripalimab-induced rhabdomyolysis in a melanoma patient
沈黎 1潘虹 2李菁锦
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 南京大学医学院附属苏州医院药学部，苏州 215153
2. 无锡市第五人民医院药剂科，无锡 214007
折叠
摘要
1例51岁女性患者行左足拇趾恶性黑色素瘤切除术后接受特瑞普利单抗240 mg静脉滴注、1次/3周治疗。第6个周期用药后第18~21天，患者先后出现腿部、脸部肿胀；第6个周期用药第28天，实验室检查中示血清肌酐（Scr）186 μmol/L、肌酸激酶（CK）4 038 U/L、CK-MB 52 U/L、乳酸脱氢酶（LDH）1 034 U/L、丙氨酸转氨酶（ALT）202 U/L、天冬氨酸转氨酶（AST）269 U/L，尿常规提示尿潜血（++）。考虑为特瑞普利单抗引起的横纹肌溶解症。给予甲泼尼龙、人免疫球蛋白、补液及碱化尿液等治疗。15 d后，患者腿部、脸部肿胀缓解，实验室检查示CK 2 132 U/L、CK-MB 32 U/L、ALT 73 U/L、AST 47 U/L、Scr 70 μmol/L；22 d后，患者腿部及脸部肿胀基本消失，实验室检查示CK 1 804 U/L、CK-MB 33 U/L、ALT 66 U/L、AST 41 U/L。 A 51-year-old female patient received an IV infusion of toripalimab 240 mg once every 3 weeks after malignant melanoma resection of the left toe. On the 18th-21st day after the 6th cycle of medication, the patient presented with notable swelling in her legs and face successively. On the 28th day after the 6th cycle of medication, laboratory tests showed serum creatinine (Scr) 186 μmol/L, creatine kinase (CK) 4 038 U/L, CK-MB 52 U/L, lactate dehydrogenase (LDH) 1 034 U/L, alanine aminotransferase (ALT) 202 U/L, aspartate aminotransferase (AST) 269 U/L, and urinary occult blood (++). Toripalimab-induced rhabdomyolysis was considered. After 15 days of treatments with methylprednisolone, human immunoglobulin, fluid replacement, and alkaline urine, the swelling in the patient′s legs and face were improved, and laboratory tests showed CK 2 132 U/L, CK-MB 32 U/L, ALT 73 U/L, AST 47 U/L, and Scr 70 μmol/L after 22 days of treatments, the swelling disappeared, and laboratory tests showed CK 1 804 U/L, CK-MB 33 U/L, ALT 66 U/L, and AST 41 U/L.
Abstract
A 51-year-old female patient received an IV infusion of toripalimab 240 mg once every 3 weeks after malignant melanoma resection of the left toe. On the 18th-21st day after the 6th cycle of medication, the patient presented with notable swelling in her legs and face successively. On the 28th day after the 6th cycle of medication, laboratory tests showed serum creatinine (Scr) 186 μmol/L, creatine kinase (CK) 4 038 U/L, CK-MB 52 U/L, lactate dehydrogenase (LDH) 1 034 U/L, alanine aminotransferase (ALT) 202 U/L, aspartate aminotransferase (AST) 269 U/L, and urinary occult blood (++). Toripalimab-induced rhabdomyolysis was considered. After 15 days of treatments with methylprednisolone, human immunoglobulin, fluid replacement, and alkaline urine, the swelling in the patient′s legs and face were improved, and laboratory tests showed CK 2 132 U/L, CK-MB 32 U/L, ALT 73 U/L, AST 47 U/L, and Scr 70 μmol/L after 22 days of treatments, the swelling disappeared, and laboratory tests showed CK 1 804 U/L, CK-MB 33 U/L, ALT 66 U/L, and AST 41 U/L.
万方数据