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特瑞普利单抗致多种免疫相关性不良事件1例
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| 篇名： | 特瑞普利单抗致多种免疫相关性不良事件1例 |
| TITLE： | A case analysis of multiple immune-related adverse event induced by toripalimab |
| 摘要： | 目的 探讨特瑞普利单抗所致多种免疫相关性不良事件（irAE）的临床特征和诊断、治疗、监护措施，为同类病例的临床管理提供参考依据。方法回顾性分析1例膀胱癌术后接受特瑞普利单抗免疫治疗后出现多种irAE的病例，详细描述了该患者的病史、实验室检查、影像学检查、治疗过程及转归情况，并采用诺氏评估量表对irAE与特瑞普利单抗的关联性进行评估。结果该例患者在接受特瑞普利单抗治疗后出现免疫相关性心肌炎、肝损伤和肌无力等irAE，经诺氏评估量表评估认为上述不良反应与特瑞普利单抗存在关联。经过大剂量糖皮质激素冲击治疗及免疫球蛋白免疫调节治疗后，患者的症状得到了有效缓解，各项生理指标均呈现好转趋势，各系统/器官损伤程度也得到显著改善。结论特瑞普利单抗可能导致包括免疫相关性心肌炎、肝损伤和肌无力在内的多种irAE。早期识别irAE、及时诊断以及合理治疗对于改善患者预后至关重要。 |
| ABSTRACT： | OBJECTIVE To explore the clinical features， diagnosis， treatment and management measures of multiple immune- related adverse event （irAE） after toripalimab treatment， in order to provide reference for the clinical management of similar cases. METHODS A retrospective analysis was conducted on a post-operative bladder cancer patient who developed various irAEs after toripalimab treatment. The patient’s medical history， laboratory tests， imaging studies， treatment course and outcomes were detailed. The Naranjo scale was used to assess the relationship between the irAEs and toripalimab. RESULTS The patient developed irAEs after receiving toripalimab， such as immune-related myocarditis， liver dysfunction， and myasthenia. According to the Naranjo scale evaluation， it was assessed that these adverse events were related to the administration of toripalimab. After high- dose corticosteroid pulse therapy and immunoglobulin immunomodulation， the patient’s symptoms were effectively relieved， with a improved trend in various physiological indicators and significant improvement in the degree of system/organ damage. CONCLUSIONS Toripalimab may lead to multiple irAEs， including immune-related myocarditis， liver injury， and myasthenia. Early recognition， timely diagnosis， and appropriate treatment of irAE are crucial for improving patient’s prognosis. |
| 期刊： | 2025年第36卷第01期 |
| 作者： | 冯振；张宇祯；谢诚 |
| AUTHORS： | FENG Zhen，ZHANG Yuzhen，XIE Cheng |
| 关键字： | 特瑞普利单抗；免疫相关性不良事件；心肌炎；肝损伤；肌无力；药物不良反应 |
| KEYWORDS： | toripalimab； immune-related adverse event； myocarditis； liver injury； myasthenia； adverse drug reaction |
| 阅读数： | 10 次 |
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