帕博利珠单抗致重度免疫相关性溃疡性结肠炎1例  

A case of severe immune-related ulcerative colitis caused by pembrolizumab

作　　者：邹金金[1] 张纪良[1] 李妮 刘定义[1] Jin-Jin ZOU;Ji-Liang ZHANG;Ni LI;Ding-Yi LIU(Department of Oncology,Chengdu Seventh People's Hospital/Affiliated Cancer Hospital of Chengdu Medical College,Chengdu 610041,China)

机构地区：[1]成都市第七人民医院/成都医学院附属肿瘤医院肿瘤科,成都610041

出　　处：《药物流行病学杂志》2023年第11期1311-1315,共5页Chinese Journal of Pharmacoepidemiology

基　　金：四川省成都市医学科研课题项目(2022159)。

摘　　要：1例57岁男性晚期肺鳞癌患者接受5周期帕博利珠单抗联合化疗及1周期单药帕博利珠单抗治疗后出现严重腹泻、腹痛及血便,结合肠镜及组织病理学检查结果诊断为结肠炎。考虑为帕博利珠单抗所致的重度免疫相关性溃疡性结肠炎,暂停免疫治疗,给予足量糖皮质激素治疗,2 d后患者腹痛、腹泻明显好转,15 d后腹痛、腹泻缓解。对帕博利珠单抗相关不良反应的文献进行复习,进一步分析免疫相关性肠炎的危险因素、临床特点及治疗策略,提高帕博利珠单抗临床应用的安全性。A 57-year-old male patient with advanced lung squamous cell carcinoma developed severe diarrhea,abdominal pain and bloody stool after receiving 5 cycles of pembrolizumab combined chemotherapy and 1 cycle of single drug pembrolizumab combined with the results of colonoscopy and histopathology,it was diagnosed as colitis,which was considered as severe immune related ulcerative colitis caused by pembrolizumab.After suspending immunotherapy and receiving sufficient glucocorticoid treatment,the patient's abdominal pain and diarrhea significantly improved 2 days later,and relieved 15 days later.In order to improve the safety of the clinical application of pembrolizumab,risk factors,clinical characteristics and treatment of immune associated colitis induced by pembrolizumab were further analyzed by reviewing the literature of the adverse reactions related to it.

关 键 词：帕博利珠单抗 肺鳞癌 重度免疫相关性溃疡性结肠炎 药品不良反应 

分 类 号：R977.15[医药卫生—药品] R574.62[医药卫生—药学]