Abstract:
Herein, we report a case of an elderly male patient who underwent extended radical resection of cardiac carcinoma after regular chemotherapy combined with sintilimab (PD-1 monoclonal antibody) immunotherapy complicated with severe pneumonitis postoperatively. We performed several treatments for aspiration pneumonitis; however, the patient\'s pulmonary infection and oxygenation were not efficiently improved. The multidisciplinary team considered it an immune checkpoint inhibitor-associated pneumonitis after diagnosis and treatment and then modified the treatment regimen. The pulmonary inflammation was effectively controlled with improved oxygenation; the patient was gradually weaned from the ventilator and finally discharged. The possibility of immune checkpoint inhibitor-associated pneumonitis should be fully considered particularly for patients with a history of immunosuppressive therapy with clinical symptoms of severe pneumonitis.
Pneumonia is well known. Immune pneumonia may be a new problem. It occurs in 2–5% of patients with immune therapy. It is a bad reaction with low incidence. If this disease is not treated in time, it will cause a relatively terrible result. The fatality rate can reach 12.8–22.7%. The most severe cases can be life threatening. At present, the reason for immune pneumonia is not clear. Some experts believe that it is related to immune change. Dyspnea, cough, fever and chest pain are symptoms of this disease. Although the incidence of immune pneumonia is very low, it should be noted. If you are on immunotherapy, consult your doctor when you feel unwell.
摘要:
在这里,我们报告了一例老年男性患者,在常规化疗联合sintilimab(PD-1单克隆抗体)免疫治疗后,接受了贲门癌的扩大根治术,术后并发严重肺炎。我们对吸入性肺炎进行了几种治疗;然而,患者的肺部感染和氧合没有得到有效改善。多学科团队在诊断和治疗后认为它是免疫检查点抑制剂相关的肺炎,然后修改了治疗方案。肺部炎症得到有效控制,氧合改善;患者逐渐脱离呼吸机,最终出院。应充分考虑免疫检查点抑制剂相关性肺炎的可能性,特别是对于有免疫抑制治疗史并有严重肺炎临床症状的患者。
肺炎是众所周知的。免疫性肺炎可能是一个新问题。它发生在2-5%的患者的免疫治疗。这是一种不良反应,发生率低。如果这种疾病不及时治疗,会造成比较可怕的结果。死亡率可达12.8-22.7%。最严重的病例可能危及生命。目前,免疫性肺炎的原因尚不清楚。一些专家认为这与免疫变化有关。呼吸困难,咳嗽,发烧和胸痛是这种疾病的症状。虽然免疫性肺炎的发病率很低,应该注意。如果你正在接受免疫疗法,当你感到不适时,请咨询你的医生。