Lymphocytic gastritis induced by pembrolizumab in a patient with metastatic melanoma
Lymphocytic gastritis induced by pembrolizumab in a patient with metastatic melanoma
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DOI：
10.1097/cmr.0000000000000502
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发表时间：
2018-12-01
影响因子：
2.2
通讯作者：
Yang, Hui-Min
中科院分区：
文献类型：
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作者：
Yip, Raymond H. L.;Lee, Lawrence H.;Yang, Hui-Min
免疫检查点抑制剂如程序性细胞死亡-1抑制剂pembrolizumab已被证明对转移性恶性肿瘤如晚期黑色素瘤有效。已描述了对多个器官的免疫相关不良反应，如结肠炎、皮疹和甲状腺功能减退症。我们报告了一例44岁男性晚期黑色素瘤和复发性肺转移瘤患者，在接受派姆单抗治疗1个月后出现消化不良和胃食管反流病症状。胃活检显示与淋巴细胞性胃炎一致的组织学特征，在开始治疗前2个月的活检中没有淋巴细胞性胃炎。在结肠中观察到了淋巴细胞浸润，可能继发于使用免疫治疗后自身免疫性增加;然而，上消化道中的此类组织学结果尚未描述。在这里，我们提出了一个淋巴细胞性胃炎的患者接受pembrolizumab治疗，这表明一个新的表现的毒性。版权所有（C）2018威科医疗集团All rights reserved.
Immune checkpoint inhibitors such as programmed cell death-1 inhibitor pembrolizumab have been shown to be effective in metastatic malignancies such as advanced melanoma. Immune-related adverse effects on multiple organs have been described, such as colitis, skin rash, and hypothyroidism. We present the case of a 44-year-old man with advanced melanoma and recurrent lung metastases who developed symptoms of dyspepsia and gastroesophageal reflux disease after 1 month of therapy with pembrolizumab. Gastric biopsy showed histologic features consistent with lymphocytic gastritis, which was absent on a biopsy 2 months before initiation of therapy. Lymphocytic infiltrates likely secondary to increased autoimmunity after use of immunotherapy have been observed in the colon; however, such histologic findings in the upper gastrointestinal tract have yet to be described. Here, we present a case of lymphocytic gastritis in a patient treated with pembrolizumab, suggesting a new manifestation of toxicity. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.