1例信迪利单抗注射液致垂体炎病例报告及文献复习  

Hypophysitis induced by sintilimab injection:a case report and literature review

作　　者：安亚会 姜紫薇 单彬[1] 邢娜 郑颖[1] An Yahui;Jiang Ziwei;Shan Bin;Xing Na;Zheng Ying(Department of Pharmacy,Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Endocrinology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Pharmacy,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]河北医科大学第四医院药学部,河北石家庄050000 [2]河北医科大学第四医院内分泌科,河北石家庄050000 [3]首都医科大学附属北京积水潭医院药学部,北京100035

出　　处：《实用药物与临床》2024年第6期442-445,共4页Practical Pharmacy and Clinical Remedies

摘　　要：免疫检查点抑制剂(Immune checkpoint inhibitors,ICIs)广泛用于肿瘤患者的治疗,其导致的免疫相关不良反应值得关注。本文报道1例肺癌患者采用化疗联合程序性死亡受体-1(Programmed death-1,PD-1)抑制剂信迪利单抗治疗2个周期,6个月后出现全身乏力伴精神行为改变、嗜睡等症状,诊断为以孤立性促肾上腺皮质激素(Adrenocorticotropic hormone,ACTH)缺乏为表现的免疫相关垂体炎、继发性肾上腺皮质功能减退症、低钠血症。经氢化可的松琥珀酸钠(50~200 mg/d)治疗后缓解,后序贯口服氢化可的松(30 mg/d),逐渐减量至生理替代治疗,停止信迪利单抗治疗。本文通过回顾已报道的文献病例,阐述免疫相关垂体炎的临床特点,为此类不良反应的临床早诊断、处理及治疗提供参考。Immune checkpoint inhibitors(ICIs)are widely used in the treatment of cancer patients,and the ICIs-induced immune-related adverse reactions are of concern.This article reported a patient with lung cancer treated with chemotherapy combined with programmed death-1(PD-1)inhibitor sintilimab for 2 cycles,who developed generalized weakness with psycho-behavioral changes,drowsiness and other symptoms half a year later and was diagnosed with immune-related hypophysitis,secondary adrenocortical insufficiency and hyponatremia,manifested as isolated adrenocotropic hormone(ACTH)deficiency.After treatment with hydrocortisone sodium succinate(50~200 mg/d),the symptoms were relieved,followed by sequential oral administration of hydrocortisone(30 mg/d),gradually the dose was reduced to physiological replacement therapy,and the sintilimab treatment was stopped.This article also reviews the literature cases to elaborate their clinical characteristics,providing a reference for the early clinical diagnosis and treatment of immune-related hypophysitis.

关 键 词：PD-1 信迪利单抗 垂体炎 不良反应 

分 类 号：R969.3[医药卫生—药理学]