纳武单抗致免疫相关性肺炎  

Immune-related pneumonia induced by nivolumab

作　　者：刘黎 龚倩[2] Liu Li;Gong Qian(Department of Pharmacy ,the Second People's Hospital of Hunan Province,Changsha 410007,China;Department of Pharmacy, Hunan Cancer Hospital, Changsha 410013, China)

机构地区：[1]湖南省第二人民医院药学部,长沙410007 [2]湖南省肿瘤医院药学部,长沙410013

出　　处：《药物不良反应杂志》2019年第1期64-66,共3页Adverse Drug Reactions Journal

摘　　要：1例68岁男性肺腺癌伴骨转移、肾上腺转移患者给予纳武单抗180mg静脉滴注(第1天,14d为1个周期),共治疗3个周期。首次用药后第70天,患者出现发热、咳嗽、咳痰、气促,给予吸氧、抗感染治疗3d,症状进行性加重。血气分析示I型呼吸衰竭,胸部CT示双肺毛玻璃样渗出影及网格状模糊影。考虑为纳武单抗所致的免疫相关性肺炎合并感染,给予大剂量甲泼尼龙抑制免疫反应,美罗培南、伏立康唑抗感染,辅予吸氧、祛痰等对症支持治疗,患者症状逐渐缓解。A 68-year-old male patient with lung adenocarcinoma and bone and adrenal metastasis received an IV infusion of nivolumab 180 mg (on day 1 of each chemotherapy cycle of 14 days), and completed 3 cycles in total. On day 70 after the first infusion, the patient developed fever, cough with sputum, and dyspnea. The above symptoms aggravated gradually despite oxygen and anti-infective treatment for 3 days. Blood gas analysis indicated type I respiratory failure. Ground glass opacities and reticular opacities in bilateral lungs were found in the chest CT. Considering the immune-related pneumonia complicated by infection induced by nivolumab, high-dose methylprednisolone was given to inhibit the immune response, meropenem and voriconazole were given to prevent infection, and oxygen and expectorants were given as the symptomatic and supportive treatments. Finally the symptoms of the patient gradually relieved.

关 键 词：肺炎 肺疾病 间质性 抗肿瘤药 程序化细胞死亡1受体 免疫 纳武单抗 

分 类 号：R563.1[医药卫生—呼吸系统]