PD-1抑制剂致免疫相关性Stevens-Johnson综合征及表皮松解症1例  

Immunorelated Stevens-Johnson syndrome/toxic epidermolysis caused by programmed death receptor 1 inhibitors:a case report

作　　者：郝红 王蔚 冉雪梅[1] 李梦琦 刘碧翠 王开金[1] Hao Hong;Wang Wei;Ran Xuemei;Li Mengqi;Liu Bicui;Wang Kaijin(Department of Respiratory and Critical Care Medicine,Bishan Hospital Affiliated to Chongqing Medical University,Chongqing 402760,China)

机构地区：[1]重庆医科大学附属璧山医院呼吸与危重症医学科,重庆402760

出　　处：《中华结核和呼吸杂志》2025年第2期142-145,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：Stevens-Johnson综合征(Stevens-Johnson syndrome,SJS)和表皮松解症(epidermalnecrolysis,TEN)是一种累及皮肤黏膜的急性严重的致死性疾病,最常见的原因是药物因素导致,其中包括各种致敏性抗生素、非甾体抗炎药等。目前尚未见程序性死亡受体1(programmed death-1,PD-1)抑制剂引起免疫相关性Stevens-Johnson综合征/表皮松解症报道。2024年4月11日重庆医科大学附属璧山医院呼吸与危重症医学科收治了1例原发性支气管肺癌男性患者。该患者因“右肺鳞癌T3N3M1bⅣA期,驱动基因KRAS G12S PD-L1阴性,PS 0分”于2024年3月25日行第3周期“替雷利珠单抗200 mg,白蛋白紫杉醇400 mg,卡铂450 mg”抗肿瘤治疗,2024年4月9日出现Stevens-Johnson综合征和表皮松解症,表皮松解面积达到95%以上,通过停用免疫抑制剂,抗感染、糖皮质激素、营养支持及免疫球蛋白等综合治疗后,患者最终治愈,顺利出院。Stevens-Johnson syndrome(SJS)and toxic epidermalnecrolysis(TEN)are acute,severe and fatal diseases involving the skin and mucous membranes,most commonly caused by pharmaceutical factors.These include various sensitizing antibiotics,non-steroidal anti-inflammatory drugs and so on.Immune-associated Stevens-Johnson syndrome/toxic epidermolysis caused by programmed death-1(PD-1)inhibitors has not been reported.On April 11,2024,a male patient with primary bronchial lung cancer(right lung squamous cell carcinoma T3N3M1bⅣA phase driver gene KRAS G12S PD-L1 negative,PS 0 score)was admitted to the department of respiratory and critical care medicine of Bishan hospital affiliated to Chongqing medical university.On March 25,2024,the patient underwent the 3rd cycle of anti-tumor therapy"Tirellizumab 200 mg+albumin paclitaxel 400 mg+carboplatin 450 mg",and on April 9,2024,Stevens-Johnson syndrome and toxic epidermolysis occurred,and the epidermolysis area reached more than 95%.After permanent discontinuation of immunosuppressants,anti-infection,hormone,nutritional support,immunoglobulin and other comprehensive treatment,the patient was eventually cured and successfully discharged.

关 键 词：表皮松解症 重庆医科大学 致死性疾病 非甾体抗炎药 药物因素 糖皮质激素 免疫球蛋白 

分 类 号：R758.25[医药卫生—皮肤病学与性病学]