Paraneoplastic Anti-Tif1-gamma Autoantibody-positive Dermatomyositis as Clinical Presentation of Hepatocellular Carcinoma Recurrence.
Paraneoplastic Anti-Tif1-gamma Autoantibody-positive Dermatomyositis as Clinical Presentation of Hepatocellular Carcinoma Recurrence.
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DOI：
10.14218/jcth.2021.00573
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发表时间：
2023-02-28
影响因子：
3.6
通讯作者：
Lenzi, Marco
中科院分区：
文献类型：
--
作者：
Ferronato, Marco;Lalanne, Claudine;Quarneti, Chiara;Cevolani, Michele;Ricci, Chiara;Granito, Alessandro;Muratori, Luigi;Lenzi, Marco
关键词：
肝细胞癌很少与自身免疫性副肿瘤综合征相关。我们报告一例抗转录中间因子-1-γ阳性的皮肌炎(DM)作为肝癌复发的临床表现，这位72岁的男性患者因疲劳、肌痛和典型的皮疹而住院。他的病史以丙型肝炎相关的肝硬变、直接作用抗病毒药物的成功治疗以及先前对肝细胞癌的有效治疗而闻名。实验室检测显示高滴度抗TIF1-γ抗体出现明显的横纹肌溶解，诊断为DM。经过仔细的诊断检查，诊断出肝细胞癌复发。在一线皮质类固醇治疗后，给予硫唑嘌呤和静脉注射免疫球蛋白治疗；不幸的是，他只有部分反应。由于表现状态不佳，没有一种肝细胞癌治疗是可行的，根据国际指南，他只得到了最好的支持性治疗。在这里，我们讨论了与副肿瘤性糖尿病相关的抗TIF1-γ抗体的诊断、预后和致病作用，以及关于其在肝细胞癌患者中发生的稀少文献数据。考虑到TIF1基因家族在肿瘤发生中的既定作用，我们还回顾了TIF1-γ作为肿瘤相关新抗原的作用，从而导致临床上抗TIF1-γ抗体阳性的DM的发展。
Hepatocellular carcinoma (HCC) is rarely associated with autoimmune paraneoplastic syndromes. We report a case of anti-transcriptional intermediary factor-1 gamma (TIF1-γ)-positive dermatomyositis (DM) as clinical presentation of HCC recurrence in a 72-year-old male patient admitted to our hospital due to fatigue, myalgia, and typical skin rash. His medical history was notable for hepatitis C-related cirrhosis, successful treatment with direct-acting antiviral agents, and previously efficacious treatment of HCC. Laboratory testing showed significant rhabdomyolysis with anti-TIF1-γ antibodies at high titer, and DM was diagnosed. After a careful diagnostic workup, HCC recurrence was diagnosed. After first-line corticosteroid treatment, azathioprine and intravenous immunoglobulin treatments were administered; unfortunately, he mounted only partial response. Owing to the compromised performance status, no HCC treatment was feasible, and, according to international guidelines, he received only best supportive care. Here, we discuss the diagnostic, prognostic, and pathogenic roles of anti-TIF1-γ antibodies associated with paraneoplastic DM and the scant literature data on its occurrence in HCC patients. Considering the TIF1 gene family’s established role in oncogenesis, we also review the role of TIF1-γ as a tumor-related neoantigen, leading to the development of clinically overt anti-TIF1-γ antibodies-positive DM.
影响因子：
1.5
作者：
Nwokediuko SC;Uchenna I;Esther O;Okechukwu O;Augustine O;Charity A
通讯作者：
Charity A