免疫检查点抑制剂(ICI)已被证明对多种晚期恶性肿瘤有益。然而,ICIs的广泛使用也伴随着各种免疫相关不良事件(irAEs).这里,我们首先报告一例sintilimab相关性膀胱炎/输尿管炎。一名53岁的男性,患有驱动基因阴性的肺腺癌(cT1cN3M1c,IVB期)正在接受紫杉醇-白蛋白和贝伐单抗联合治疗,作为二线治疗。他因血尿住院,Polakiuria,三个疗程后排尿疼痛和腰背痛。尿液分析显示红细胞(RBC)和白细胞(WBC)明显增多,血清肌酐(sCr)水平也显着升高。尿培养和细胞学检查均为阴性,膀胱镜检查示膀胱粘膜弥漫性发红。尿超声检查显示轻度肾积水和输尿管扩张。在多学科小组(MDT)会议后,患者被诊断为免疫治疗相关膀胱炎/输尿管炎。一旦做出诊断,给予皮质类固醇治疗,迅速解决了病人的症状和体征。在sCr水平恢复正常并显示输尿管扩张和输尿管后,进行计算机断层扫描血管造影(CTA)和CT尿路造影(CTU)。一旦症状缓解,进行膀胱活检并确认膀胱炎症。随后将患者改为甲基强的松龙的维持剂量并逐渐减量。由于sintilimab已用于晚期恶性肿瘤,我们首先报告了一例罕见的sintilimab诱导的膀胱炎/输尿管炎病例,并总结了sintilimab相关的不良事件,以改善irAE的评估和管理.
Immune checkpoint inhibitors (ICIs) have been proven to be beneficial in multiple advanced malignancies. However, the widespread use of ICIs also occurred with various immune-related adverse events (irAEs). Here, we first report a case of sintilimab-related cystitis/
ureteritis. A 53-year-old man with driver gene-negative pulmonary adenocarcinoma (cT1cN3M1c, Stage IVB) was being treated with sintilimab in combination of paclitaxel-albumin and bevacizumab as second-line treatment. He was hospitalized for haematuria, pollakiuria, painful micturition and low back pain after three courses. Urinalysis showed red blood cells (RBCs) and white blood cells (WBCs) were obviously increased, and serum creatinine (sCr) level was also significantly elevated. Urine culture and cytology were both negative, and cystoscopy revealed diffused redness of bladder mucosa. Urinary ultrasonography showed mild hydronephrosis and dilated ureter. The patient was diagnosed as immunotherapy-related cystitis/
ureteritis after a multidisciplinary team (MDT) meeting. Once the diagnosis was made, corticosteroid therapy was given, which rapidly resolved the patient\'s symptoms and signs. Computer tomography angiography (CTA) and CT urography (CTU) was conducted after sCr level was back to normal and demonstrated ureter dilation and hydroureter. Once symptoms relieved, bladder biopsy was performed and confirmed the bladder inflammation. The patient was subsequently switched to maintenance dose of methylprednisolone and tapered gradually. Since sintilimab has been used in advanced malignancies, we first reported a rare case of sintilimab-induced cystitis/
ureteritis and summarized sintilimab-related adverse events to improve the assessment and management of irAEs.