Abstract:
Immune checkpoint inhibitors (ICIs) are used to treat a variety of tumors. Despite their broad beneficial effects, these inhibitors can cause immune-related adverse events (irAEs) and even death. Hemophagocytic lymphohistiocytosis (HLH) and meningitis, although infrequent, can be aggressive and life-threatening due to excessive immune activation. Herein, we report a case of an 80-year-old man who developed HLH after receiving atezolizumab monotherapy as a second-line treatment for lung adenocarcinoma. He was treated for HLH with oral prednisolone (PSL), but further ataxia and dysuria developed, and a lumbar puncture diagnosed meningitis. Both HLH and meningitis improved with continued oral PSL treatment. This is the first case of atezolizumab-induced HLH with meningitis and highlights the importance of early diagnosis and treatment for rare irAE.
摘要:
免疫检查点抑制剂(ICI)用于治疗多种肿瘤。尽管它们具有广泛的有益影响,这些抑制剂可引起免疫相关不良事件(irAEs)甚至死亡.噬血细胞淋巴组织细胞增多症(HLH)和脑膜炎,虽然不常见,由于过度的免疫激活,可能具有攻击性和危及生命。在这里,我们报道了一例80岁男性患者,他在接受阿特珠单抗单药治疗作为肺腺癌二线治疗后出现HLH.他使用口服泼尼松龙(PSL)治疗HLH,但是共济失调和排尿困难进一步发展,腰椎穿刺诊断为脑膜炎.继续口服PSL治疗后,HLH和脑膜炎均得到改善。这是首例阿特珠单抗诱导的HLH伴脑膜炎,突出了早期诊断和治疗罕见irAE的重要性。