Nivolumab-induced Acute Fibrinous and Organizing Pneumonia (AFOP).
Nivolumab-induced Acute Fibrinous and Organizing Pneumonia (AFOP).
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DOI：
10.2169/internalmedicine.8271-16
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发表时间：
2017-09-01
期刊：
影响因子：
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通讯作者：
Takiguchi Y
中科院分区：
文献类型：
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作者：
Ishiwata T;Ebata T;Iwasawa S;Matsushima J;Ota S;Nakatani Y;Tsushima K;Tada Y;Tatsumi K;Takiguchi Y
尽管已知nivolumab会引起免疫相关的间质性肺病（ILD），但ILD的详细特征仍未完全了解。一名68岁的男性因不可切除的鼻窦黑色素瘤接受纳武单抗治疗，他在治疗开始后不久获得完全缓解，此后完全缓解维持30周，直至患者发生亚急性发作的呼吸困难。CT图像显示斑片状浸润和磨玻璃样影。支气管肺泡灌洗液（BALF）中淋巴细胞（53%）和中性粒细胞（30%）的百分比升高。经支气管肺活检显示肺泡内纤维蛋白球，无透明膜，这被认为是符合急性化脓性和机化性肺炎（AFOP）的模式。这是纳武单抗诱导AFOP的首次报道。
Although nivolumab is known to cause immune-related interstitial lung diseases (ILD), the detailed characteristics of ILD are still not fully understood. A 68-year-old man was treated with nivolumab because of unresectable sinonasal melanoma, he achieved a complete response soon after the initiation of the therapy and a complete response was thereafter maintained for 30 weeks until the patient experienced dyspnea of subacute onset. CT images revealed patchy infiltrates and ground-glass opacifications. The bronchoalveolar lavage fluid (BALF) contained elevated percentages of lymphocytes (53%) and neutrophils (30%). A transbronchial lung biopsy revealed intraalveolar fibrin balls without hyaline membranes, which was considered to be consistent with the pattern of acute fibrinous and organizing pneumonia (AFOP). This is the first report of AFOP induced by nivolumab.