免疫治疗引起的心肌炎:一种罕见但致命的并发症

P. M. Mulendelé, M. Njie, M. Charfo, G. M. Lukifimpa, M. S. Boutar, B. E. Ovaga, M. Haboub, S. Arous, M. Benouna, A. Drighil, L. Azzouzi, R. Habbal
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引用次数: 0

摘要

免疫疗法的出现及其在肿瘤学适应症的逐渐扩大需要特别警惕,以发现并迅速处理潜在的心脏毒性。它们改善了预后和生存率,包括患有肾癌、肺癌或皮肤癌(黑色素瘤)和某些淋巴瘤的患者。在免疫治疗下,意外心脏事件的发生率很低,毫无疑问,在Ipilimab、Pembrolizumab和Nivolumab下,发生率低于1%。心脏毒性可以由许多药物引起,但这次我们关注的是由免疫调节剂引起的心肌炎,这是一种罕见但非常致命的并发症,主要有两个部分:一个临床病例的说明和文献综述,包括概况,病理生理学,临床表现,诊断策略和治疗管理,基于欧洲心脏病学会心脏肿瘤学最近发表于2022年的指南。糖皮质激素是治疗免疫治疗引起的心脏毒性的有效药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Myocarditis Induced by Immunotherapy: A Rare but Fatal Complication
The emergence of immunotherapy and the gradual expansion of its indications in oncology will require particular vigilance to detect and quickly take care of the potential cardiac toxicities. They have improved prognosis and survival, including patients with kidney, lung or skin cancers (melanoma) and certain lymphomas. The incidence of unwanted cardiac events under immunotherapy is rare, undoubtedly less than 1 % under Ipilimab, Pembrolizumab and Nivolumab. Cardiac toxicity can be induced by many drugs but this time we focused on myocarditis induced by immuno-modulators, which is a rare but very fatal complication and has 2 main parts: an illustration of a clinical case and a review of the literature comprising generality, pathophysiology, clinical manifestations, diagnostic strategy and therapeutic management based on the guidelines of the European Society of cardiology on cardio-oncology recently published in 2022. Corticosteroids are drugs effective in the treatment of cardiac toxicity induced by immunotherapy.
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