Multiple immune related adverse events with special clinical manifestations: A case report

doi:10.3969/j.issn.1004-583X.2023.07.009

Abstract

Abstract:

Objective To report a case of special clinical manifestations of multi system immune related adverse events, discuss the mechanism and risk factors of immune related adverse reactions in this case, and improve the understanding of the disease. Methods The clinical data, diagnosis and treatment process of this patient were analyzed, and the related literature was reviewed for discussion. Results In this patient with special clinical manifestations of multiple immune related adverse events, immune related pneumonia was G3, immune related hepatitis was G2, and immune related endocrine toxicity was G2. He still died after the symptoms improved. Conclusion The special clinical manifestations of multi system immune related adverse events are rare, and the pathogenesis and risk factors of treatment are still controversial. Although the incidence is low, the prognosis is poor, which is worth further study.

Key words: programmed death-1 inhibitor, camrelizumab, rare clinical manifestations, immune related adverse events

CLC Number:

R736.1

Li Yang, Mo Feng, Xin Zhifei, Wang Qian, Deng Xinna. Multiple immune related adverse events with special clinical manifestations: A case report[J]. Clinical Focus, 2023, 38(7): 633-637.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.07.009

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I7/633

Figures/Tables 8

Fig.1 Imaging findings before immunotherapy (2021-12-22) a. Pre-immunotherapy PET/CT; b, c. Pre-immunotherapy CT

Fig.2 Lung pathological section(HE×10)

Fig.3 Thyroid pathological section(HE×10)

Fig.4 Sputum specimen

Fig.5 Bronchoscope display a.End of main bronchus of left lung; b. Tracheal carina

Fig.6 Sputum pathological(HE× 10)

Fig.7 Clinical course

Fig.8 The CT image showing pneumonia change a, b. On the 23rd day (2022-01-22), CT findings of pneumonia; c, d. On the 29th day (2022-01-28), CT imaging showed the changes of pneumonia; e, f. On the 36th day (2022-02-04), CT imaging showed the changes of pneumonia; g, h. On the 51st day (2022-02-19), the symptoms disappeared and pneumonia basically

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