子宫内膜癌免疫治疗相关毛细血管渗漏综合征1例报告及文献复习

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-09-12 DOI:10.1016/j.gore.2025.101955

Katherine Lambert , Quinn Kistenfeger , Julia Chalif , Jason M. Prosek , Floor Backes

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引用次数: 0

摘要

背景：毛细血管渗漏综合征是一种罕见的免疫不良相关事件。在接受派姆单抗治疗的患者中，仅报道了3例毛细血管渗漏综合征，均为非妇科鳞状细胞癌患者。在这里，我们提出一个病例报告毛细血管渗漏综合征的患者复发子宫内膜癌接受派姆单抗。方法结合病例报告和相关文献进行复习。在开始报告和提交给期刊之前获得患者同意。我们描述了一名65岁的女性，她患有复发性错配修复缺陷（dMMR） FIGO 2级子宫内膜样腺癌，接受派姆单抗维持治疗，她以疲劳、下肢血管炎、疼痛和不明原因的发烧来医院就诊。她被发现有低白蛋白血症和低钠血症。进行了广泛的检查，总体上没有发现任何问题。她被诊断为毛细血管渗漏综合征作为排除诊断。患者接受皮质类固醇和IVIG治疗，症状得到缓解。该患者目前没有接受任何维持治疗，也没有恢复使用派姆单抗的计划。结论本病例是首例报告的派姆单抗继发于妇科恶性肿瘤患者的毛细血管渗漏综合征。毛细血管渗漏综合征是一种排除性诊断，并通过免疫抑制药物治疗，如皮质类固醇和IVIG。扩大对这一免疫相关不良事件的认识对于及时识别和治疗至关重要。

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Immunotherapy-associated capillary leak syndrome in endometrial cancer: a case report and review of the literature

Background

Capillary leak syndrome is a rare immune-adverse related event. There are only 3 reported cases of capillary leak syndrome in patients receiving pembrolizumab, all of which are patients with non-gynecologic squamous cell carcinomas. Here, we present a case report of capillary leak syndrome in a patient with recurrent endometrial carcinoma receiving pembrolizumab.

Methods

This is a case report and review of relevant literature. Patient consent was obtained prior to initiation of the report and submission to the journal.

Objectives

We describe a 65-year-old female with recurrent mismatch repair deficient (dMMR) FIGO grade 2 endometrioid adenocarcinoma on pembrolizumab maintenance therapy, who presented to the hospital with fatigue, lower extremity vasculitis, anasarca, and fevers of unknown origin. She was found to have hypoalbuminemia and hyponatremia. A broad workup was performed, which was overall unrevealing. She was diagnosed with capillary leak syndrome as a diagnosis of exclusion. The patient was treated with corticosteroids and IVIG with resolution of her symptoms. The patient is not currently on any maintenance therapy and there are no plans to resume pembrolizumab.

Conclusion

Our case is the first reported case of capillary leak syndrome secondary to pembrolizumab in a patient with a gynecologic malignancy. Capillary leak syndrome is a diagnosis of exclusion and is treated via immunosuppression with agents such as corticosteroids and IVIG. Expanded awareness of this immune-related adverse event is vital to prompt recognition and treatment.

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.