Sonographic Findings in Inflammatory Arthritis Secondary to Immune Checkpoint Inhibition: A Case Series
Sonographic Findings in Inflammatory Arthritis Secondary to Immune Checkpoint Inhibition: A Case Series
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DOI：
10.1002/acr2.1026
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发表时间：
2019-07-01
影响因子：
3.4
通讯作者：
Cappelli, Laura
中科院分区：
文献类型：
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作者：
Albayda, Jemima;Dein, Eric;Cappelli, Laura
免疫检查点抑制剂（ICI）正在改变肿瘤领域，导致多种晚期癌症的肿瘤消退。通过本病例系列，我们回顾了一系列ici诱导的炎症性关节炎（IA）患者的超声成像结果，IA是一种由癌症免疫治疗引起的新型风湿性疾病。方法：我们对风湿病学家诊断的、ici诱发的IA患者进行了肌肉骨骼超声检查，用于临床护理。回顾性回顾图表，以获得人口统计学、肿瘤学史、临床表现、影像学和滑液结果。回顾超声图像并对滑膜和肌腱病理、多普勒存在和骨侵蚀进行评分。结果9例患者纳入本研究，共评估了18个关节区域。膝盖是最常被成像的关节，其次是手、手腕、脚和脚踝。滑膜炎见于18个关节中的12个，50%的病例有活动多普勒。肌腱受累也很常见（18个关节中有13个），伴有腱鞘炎、肌腱炎和内生真菌。腐蚀较少，仅在3例中见过，但也是早期发现。结论ci诱发的IA患者在肌肉骨骼超声上表现为滑膜、肌腱和骨骼的广泛病变。这类疾病需要进一步系统的影像学研究。
ObjectiveImmune checkpoint inhibitors (ICI) are transforming the field of oncology, leading to tumor regression in multiple advanced cancers. With this case series, we review the ultrasound imaging findings in a series of patients with ICI-induced inflammatory arthritis (IA), a novel rheumatic disease that is caused by cancer immunotherapy.MethodsWe identified patients with rheumatologist-diagnosed, ICI-induced IA who had musculoskeletal ultrasound performed for clinical care. A retrospective chart review was done to obtain demographics, oncologic history, clinical presentation, imaging, and synovial fluid results. Ultrasound images were reviewed and scored for synovial and tendon pathology, presence of Doppler, and bony erosion.ResultsNine patients were included in this study with a total of 18 joint regions assessed. The knees were the most commonly imaged joint followed by the hands, wrists, feet, and ankles. Synovitis was seen in 12 of the 18 joints with active Doppler in 50% of the cases. Tendon involvement was also frequently seen (13 of 18 joints) with tenosynovitis, tendinitis, and enthesophytes. Erosions were less frequent and seen in only three cases but were also an early finding.ConclusionPatients with ICI-induced IA had a wide range of pathology affecting the synovium, tendons, and bones on musculoskeletal ultrasound. Further systematic study with imaging is needed for this group of diseases.