Large-vessel vasculitis induced by pegfilgrastim and immune checkpoint inhibitor in a patient with small-cell lung cancer.

pegfilgrastim 和免疫检查点抑制剂在小细胞肺癌患者中诱导的大血管血管炎。

• 发表时间: 2024 Feb
• 来源期刊: Respirol Case Rep
• DOI: 10.1002/rcr2.1291
• PMID: 38328632
• 文章类型: Case Reports
• 作者列表: Shiraha K,Takigawa Y,Sato A,Fujiwara K,Matsuo Y,Goda M,Inoue T,Nakamura E,Fujiwara M,Matsuoka S,Watanabe H,Kudo K,Sato K,Shibayama T

关键词: immune checkpoint inhibitor; immune‐related adverse event; large‐vessel vasculitis; pegfilgrastim; small‐cell lung cancer

Abstract

A 75-year-old woman with stage IVB (cT3N3M1c) extensive disease small-cell lung cancer was treated with carboplatin, etoposide, and atezolizumab. Ten days after pegfilgrastim initiation, during the second chemotherapy cycle, she experienced back pain. Contrast-enhanced computed tomography revealed soft tissue thickening around the descending aorta and brachiocephalic artery. She was diagnosed with atezolizumab and pegfilgrastim-induced large-vessel vasculitis (LVV) and was treated with prednisolone, which was tapered and discontinued after 14 weeks, with no symptom recurrence. LVV should be included in the differential diagnosis of patients with nonspecific body pain when pegfilgrastim and immune checkpoint inhibitors are used in combination.

摘要

一名75岁的IVB期（cT3N3M1c）广泛疾病小细胞肺癌患者接受卡铂治疗，依托泊苷,和阿妥珠单抗。pegfilgrastim入会十天后，在第二个化疗周期，她经历了背部疼痛。对比增强计算机断层扫描显示降主动脉和头臂动脉周围的软组织增厚。她被诊断为阿特珠单抗和聚乙二醇格司亭诱导的大血管血管炎（LVV），并接受了泼尼松龙治疗。它逐渐变细并在14周后停止，没有症状复发。当pegfilgrastim和免疫检查点抑制剂联合使用时，LVV应包括在非特异性身体疼痛患者的鉴别诊断中。