信迪利单抗致免疫相关性膀胱炎和膀胱结核  

Immune-related cystitis and bladder tuberculosis induced by sintilimab

作　　者：王冰[1] 王泉[1] 隋晓晶 李进峰 崔瑛洁 张媛[1] Wang Bing;Wang Quan;Sui Xiaojing;Li Jinfeng;Cui Yingjie;Zhang Yuan(Department of Pharmacy,Weihai Municipal Hospital,Cheeloo College of Medicine,Shandong University,Shandong Province,Weihai 264200,China)

机构地区：[1]山东大学附属威海市立医院药剂科,威海264200

出　　处：《药物不良反应杂志》2024年第10期636-638,共3页Adverse Drug Reactions Journal

摘　　要：1例67岁男性食管癌患者接受信迪利单抗+化疗[信迪利单抗注射液200 mg静脉滴注、化疗前1天+紫杉醇(白蛋白结合型)200 mg静脉滴注第1天、300 mg第5天+奈达铂静脉滴注80 mg第1天、70 mg第2天,21 d为1个周期],共治疗4个周期。此后因出现纵膈淋巴结转移,接受信迪利单抗+姑息性放疗1次,8 d后出现尿频、尿急、尿痛,尿常规示红细胞638个/μl、白细胞2141个/μl,结核杆菌感染T细胞检测结果阳性,膀胱镜检查示膀胱黏膜弥漫性红肿,诊断为免疫相关性膀胱炎和膀胱结核,考虑与信迪利单抗有关。予甲泼尼龙琥珀酸钠和抗结核治疗。治疗5 d后患者前述症状缓解,尿常规恢复正常。此后未再使用信迪利单抗,患者未再出现相关症状。A 67-year-old male patient with esophageal cancer received sintilimab and chemotherapy[sintilimab injection 200 mg by IV infusion,1 day before chemotherapy,paclitaxel(albumin bound)200 mg by IV infusion on day 1 and 300 mg on day 5,and nedaplatin 80 mg by IV infusion on day 1 and 70 mg on day 2,21 days as 1 cycle]for 4 cycles.Later,due to mediastinal lymph node metastasis,the patient received sintilimab and palliative radiotherapy one time.Eight days later,the patient developed urinary frequency,urgency and pain,urine routine showed 638 red blood cells/μl,and 2141 white blood cells/μl.The T-cell test for mycobacterium tuberculosis infection was positive,and cystoscopy showed diffuse redness and swell-ing of bladder mucosa.The patient was diagnosed with immune-related cystitis and bladder tuberculosis,which was considered to be related to sintilimab.Methylprednisolone sodium succinate and anti-tuberculosis treatment were given.After 5 days of treatments,the patient′s aforementioned symptoms were improved and the urine routine returned to normal.Afterwards,sintilimab was not used again and relevant symptoms did not recur.

关 键 词：膀胱炎 结核 泌尿生殖系统 免疫检查点抑制剂 信迪利单抗 免疫相关性不良反应 

分 类 号：R969.3[医药卫生—药理学]