免疫检查点抑制剂治疗后与免疫球蛋白 G4 相关的自身免疫性胰腺炎和垂体功能减退症：病例报告。

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Internal Medicine Pub Date : 2025-01-15 Epub Date: 2024-05-30 DOI:10.2169/internalmedicine.3591-24

Saori Inoue, Yukiko Tsunoda, Kana Yamamoto, Hideki Okamoto

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引用次数: 0

摘要

一名 70 岁的男子因患肾细胞癌接受了肾切除术，随后接受了 3 个周期的 pembrolizumab 辅助化疗。三个月后，他抱怨食欲不振。他被诊断为继发性肾上腺功能不全和胰腺肿瘤。淀粉酶和免疫球蛋白 G (IgG) 4 水平正常。鉴别诊断对鉴别胰腺癌、肾细胞癌转移和自身免疫性胰腺炎提出了挑战，因此必须进行肿瘤切除手术。组织学检查显示，患者患有 IgG4 相关的硬化性胰腺炎。术后，胰腺炎没有复发。在使用免疫检查点抑制剂后，必须考虑可能出现的 IgG4 相关疾病。

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Immunoglobulin G4-related Autoimmune Pancreatitis and Hypopituitarism Following Immune Checkpoint Inhibitor Therapy.

A 70-year-old man underwent nephrectomy for renal cell carcinoma followed by 3 cycles of pembrolizumab as adjuvant chemotherapy. Three months later, he complained of appetite loss. He was diagnosed with secondary adrenal insufficiency and pancreatic tumor. Amylase and immunoglobulin G (IgG) 4 levels were normal. The differential diagnosis poses challenges in distinguishing pancreatic cancer, renal cell carcinoma metastasis, and autoimmune pancreatitis, necessitating tumor resection surgery. A histological examination revealed IgG4-related sclerosing pancreatitis. Postoperatively, there was no recurrence of pancreatitis. It is essential to consider the potential development of IgG4-related diseases after the administration of immune checkpoint inhibitors.

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来源期刊

Internal Medicine 医学-医学：内科

CiteScore

1.90

自引率

8.30%

发文量

审稿时长

2.2 months

期刊介绍： Internal Medicine is an open-access online only journal published monthly by the Japanese Society of Internal Medicine. Articles must be prepared in accordance with "The Uniform Requirements for Manuscripts Submitted to Biomedical Journals (see Annals of Internal Medicine 108: 258-265, 1988), must be contributed solely to the Internal Medicine, and become the property of the Japanese Society of Internal Medicine. Statements contained therein are the responsibility of the author(s). The Society reserves copyright and renewal on all published material and such material may not be reproduced in any form without the written permission of the Society.