阿特珠单抗联合贝伐单抗治疗肝细胞癌期间的一例免疫相关性无菌性脑膜炎病例。

IF 0.5 Q4 GASTROENTEROLOGY & HEPATOLOGY Case Reports in Gastroenterology Pub Date : 2024-01-04 eCollection Date: 2024-01-01 DOI:10.1159/000535476
Hiroki Kawanaka, Kazuto Tajiri, Nozomu Muraishi, Aiko Murayama, Takamasa Nukui, Ichiro Yasuda
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引用次数: 0

摘要

导言:免疫检查点抑制剂在治疗期间或治疗后有时会出现与免疫相关的不良事件。其中,无菌性脑膜炎是一种罕见的严重并发症。我们报告了首例阿特珠单抗诱发无菌性脑膜炎的病例,该病例发生在晚期肝细胞癌(HCC)的治疗过程中:一名被诊断为晚期肝细胞癌并接受一线阿特珠单抗加贝伐单抗治疗的74岁女性,在三个治疗周期后出现厌食、乏力和发热。脑脊液检查显示细胞计数和蛋白水平略有升高,但未发现感染或恶性肿瘤。对比增强磁共振成像显示沿脑沟的对比增强明显,患者被诊断为与阿特珠单抗相关的无菌性脑膜炎。类固醇治疗很快改善了她的临床症状,沿脑沟的造影剂强化也消失了:临床医生在使用免疫检查点抑制剂治疗 HCC 期间应进行监测,避免患者出现严重的免疫相关不良事件,如无菌性脑膜炎,并尽快做出诊断。
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A Case of Immune-Related Aseptic Meningitis during Atezolizumab plus Bevacizumab for Hepatocellular Carcinoma.

Introduction: Immune checkpoint inhibitors are sometimes associated with immune-related adverse events during or after treatment. Among these, aseptic meningitis is a rare and serious complication. We report the first case of atezolizumab-induced aseptic meningitis, which occurred during treatment for advanced hepatocellular carcinoma (HCC).

Case presentation: A 74-year-old woman diagnosed with advanced HCC and treated with first-line atezolizumab plus bevacizumab developed anorexia, fatigue, and fever, after three treatment cycles. Cerebrospinal fluid examination showed slightly increased cell count and protein level but no infection or malignancy. Contrast enhancement along the cerebral sulcus was evident in contrast-enhanced magnetic resonance imaging, and the patient was diagnosed with aseptic meningitis associated with atezolizumab. Steroid therapy soon improved her clinical symptoms, and the contrast enhancement along the cerebral sulcus disappeared.

Conclusion: Clinicians should monitor to avoid serious immune-related adverse events, such as aseptic meningitis, in patients during treatment of HCC with immune checkpoint inhibitors and make the diagnosis as soon as possible.

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Case Reports in Gastroenterology
Case Reports in Gastroenterology Medicine-Gastroenterology
CiteScore
1.10
自引率
0.00%
发文量
99
审稿时长
7 weeks
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