PDF(Pubmed)
Abstract：
Zanubrutinib is a Bruton tyrosine kinase (BTK) inhibitor used in B cell malignancy treatment and is generally well tolerated in most patients. Zanubrutinib-induced aseptic meningitis is currently not reported. Herein, we present the first case of zanubrutinib-induced aseptic meningitis. A 33-year-old woman was diagnosed with relapsed/refractory follicular lymphoma and subsequently developed aseptic meningitis after receiving zanubrutinib treatment. We reviewed the literature and uncovered the lack of current reports on zanubrutinib or other BTK inhibitor-induced aseptic meningitis. Moreover, we summarized cases on aseptic meningitis induced by common chemotherapy and targeted drugs used for hematological diseases. Drug-induced aseptic meningitis (DIAM) is a drug-induced meningeal inflammation. The possible pathogenesis is the direct stimulation of the meninges via intrathecal injection of chemotherapy drugs and immune hypersensitivity response caused by immunosuppressive drugs. It is more common in women with immune deficiency and mainly manifests as persistent headache and fever. Cerebrospinal fluid examinations mainly demonstrate a significant increase in cells and proteins. DIAM diagnosis needs to exclude bacterial, fungal, viral, and tuberculosis infections; neoplastic meningitis; and systemic diseases involving the meninges. The prognosis of DIAM is usually favorable, and physicians should detect and stop the causative drug. In conclusion, zanubrutinib-induced aseptic meningitis is a rare but serious complication, and physicians should be promptly aware of this adverse event to avoid serious consequences.
摘要：
Zanubrutinib是用于B细胞恶性肿瘤治疗的布鲁顿酪氨酸激酶（BTK）抑制剂，通常在大多数患者中耐受性良好。目前尚未报道Zanubrutinib引起的无菌性脑膜炎。在这里，我们介绍了第一例zanubrutinib诱导的无菌性脑膜炎。一名33岁的妇女在接受zanubrutinib治疗后被诊断为复发性/难治性滤泡性淋巴瘤，随后发展为无菌性脑膜炎。我们回顾了文献，发现目前缺乏关于扎努布替尼或其他BTK抑制剂诱导的无菌性脑膜炎的报道。此外，我们总结了常见化疗和血液病靶向药物诱发无菌性脑膜炎的病例。药物诱导的无菌性脑膜炎(DIAM)是一种药物诱导的脑膜炎症。可能的发病机制是通过鞘内注射化疗药物直接刺激脑膜和免疫抑制药物引起的免疫超敏反应。它在免疫缺陷女性中更常见，主要表现为持续头痛和发烧。脑脊液检查主要显示细胞和蛋白质的显着增加。DIAM诊断需要排除细菌，真菌,病毒，和结核感染;肿瘤性脑膜炎;和涉及脑膜的全身性疾病。DIAM的预后通常是有利的，医生应该检测并停止致病药物。总之,zanubrutinib引起的无菌性脑膜炎是一种罕见但严重的并发症，医生应及时意识到这一不良事件，以避免严重后果。
