联合应用纳武单抗与伊匹木单抗致免疫相关性心肌炎

来源 :药物不良反应杂志 | 被引量 : 0次 | 上传用户:kok671113
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
1例63岁男性患者因膀胱癌肺转移接受纳武单抗(1 mg/kg)和伊匹木单抗(3 mg/kg)静脉滴注,1次/21 d。第2次用药后第3天,患者出现发作性胸闷,平卧数分钟后可自行缓解,实验室检查示超敏肌钙蛋白Ⅰ4 340 ng/L,肌酸激酶(CK)-MB 98.9 μg/L。考虑为纳武单抗和伊匹木单抗所致免疫相关性心肌炎。经甲泼尼龙序贯泼尼松治疗以及补液、保肝护胃、改善心肌代谢、降低氧耗等对症支持治疗后,患者症状明显好转,复查超敏肌钙蛋白Ⅰ 192 ng/L,CK-MB 28.4 μg/L。“,”A 63-year-old male patient with lung metastases from bladder cancer received IV infusions of nivolumab (1 mg/kg) and ipilimumab (3 mg/kg) once every 21 d. On day 3 after the second medication, the patient developed paroxysmal chest tightness, which could be self-mitigated by lying down for several minutes. Laboratory tests showed high-sensitive troponin Ⅰ 4 340 ng/L and creatine kinase (CK)-MB 98.9 μg/L. Immune-related myocarditis due to combination use of nivolumab and ipilimumab was considered. After methylprednisolone with prednisone sequentially and symptomatic and supportive treatments such as fluid infusion, liver and stomach protection, improvement of myocardial metabolism, and reduction of oxygen consumption, the patient′s symptoms were improved obviously. Laboratory tests showed high-sensitive troponin Ⅰ 192 ng/L and CK-MB 28.4 μg/L.
其他文献
1例77岁男性患者行经直肠前列腺穿刺活检前为预防感染予左氧氟沙星0.5 g静脉滴注。静脉滴注结束后3 h,患者躯干、臀部、四肢出现红斑伴瘙痒,2 d后出现发热,皮疹加重和大面积水疱
1例31岁男性患者因肺部感染给予莫西沙星400 mg口服、1次/d。用药9 d后出现咯血、便血和全身散在瘀点、瘀斑,血小板计数(PLT)1×10n 9/L,诊断为血小板减少性紫癜。停用莫西沙
1例55岁男性肝复杂泡型包虫病患者有痛风病史4年余,入院等待远程会诊结果和准备接受择期右半肝切除术时,出现双足肿胀、皮温高等症状。实验室检查示尿酸530 μmol/L,风湿因子阴