免疫检查点抑制剂致细胞因子释放综合征1例

doi:10.16352/j.issn.1001-6325.2022.11.1764

基础医学与临床 ›› 2022, Vol. 42 ›› Issue (11): 1764-1766.doi: 10.16352/j.issn.1001-6325.2022.11.1764

免疫检查点抑制剂致细胞因子释放综合征1例

斯晓燕, 王汉萍, 张力, 王孟昭, 张晓彤^*

中国医学科学院北京协和医学院北京协和医院呼吸与危重症医学科,北京 100730

收稿日期:2022-08-15 修回日期:2022-09-21 出版日期:2022-11-05 发布日期:2022-11-01
通讯作者: ^* zhangxtpumch@126.com

Cytokine release syndrome caused by immune checkpoint inhibitor: a case report

SI Xiao-yan, WANG Han-ping, ZHANG Li, WANG Meng-zhao, ZHANG Xiao-tong^*

Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China

Received:2022-08-15 Revised:2022-09-21 Online:2022-11-05 Published:2022-11-01
Contact: ^* zhangxtpumch@126.com

摘要/Abstract

摘要： 目的探讨免疫检查点抑制剂(ICI)导致的细胞因子释放综合征(CRS)的诊断和治疗。方法回顾性分析1例北京协和医院呼吸与危重症医学科收治的肺癌患者在接受ICI帕博利珠单抗后出现CRS的诊治资料。结果患者在接受帕博利珠单抗后出现发热、低血压、炎性指标明显升高、肝功能异常,结合临床无明确的病原学证据、抗感染无效后,考虑CRS,予糖皮质激素及白介素6受体单克隆抗体托珠单抗后,患者病情好转。结论 ICIs抑制剂可导致CRS,病情重、发展快、预后差,临床中需要引起重视。糖皮质激素联合细胞因子抑制剂有可能成为一种有效的治疗措施。

关键词: 免疫检查点抑制剂, 细胞因子释放综合征, 全身炎性反应综合征, 肺癌

Abstract: Objective To investigate the diagnosis and treatment of cytokine release syndrome (CRS) caused by immune checkpoint inhibitor(ICI). Methods A case of ICI pembrolizumab leading to CRS was analyzed in Department of Pulmonary and Critical Care Medicine of Peking Union Medical College Hospital. ResultsA 52-year-old woman with advanced adenosquamous lung cancer developed fever and hypotension after receiving pembrolizumab. Results of laboratory test showed an obviously increased serum ferritin, C response protein, interleukin-6 and abnormal liver function. Without positive infectious results, she was ultimately diagnosed as CRS. The patient was treated with steroids and tocilizumab with good clinical response. Conclusions CRS caused by ICIs develops rapidly and lead to severe results. It is important to consider CRS in patient who developed systemic inflammatory response syndrome after ICIs. Steroids combined tocilizumab is a potential choice of treatment.

Key words: immune checkpoint inhibitor, cytokine release syndrome, systemic inflammatory response syndrome, lung cancer

中图分类号:

R734.2

斯晓燕, 王汉萍, 张力, 王孟昭, 张晓彤. 免疫检查点抑制剂致细胞因子释放综合征1例[J]. 基础医学与临床, 2022, 42(11): 1764-1766.

SI Xiao-yan, WANG Han-ping, ZHANG Li, WANG Meng-zhao, ZHANG Xiao-tong. Cytokine release syndrome caused by immune checkpoint inhibitor: a case report[J]. Basic & Clinical Medicine, 2022, 42(11): 1764-1766.

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免疫检查点抑制剂致细胞因子释放综合征1例

Cytokine release syndrome caused by immune checkpoint inhibitor: a case report

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