Thiamine deficiency in a patient with recurrent renal cell carcinoma who developed weight loss with normal appetite and loss of energy soon after nivolumab treatment
Thiamine deficiency in a patient with recurrent renal cell carcinoma who developed weight loss with normal appetite and loss of energy soon after nivolumab treatment
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复发性肾细胞癌患者缺乏硫胺素，在纳武利尤单抗治疗后不久出现体重减轻、食欲正常和精力丧失
DOI：
10.1017/s1478951519000658
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发表时间：
2019
影响因子：
2.2
通讯作者：
Ishida Mayumi
中科院分区：
文献类型：
--
作者：
Onishi Hideki;Okabe Takashi;Uchida Nozomu;Shirotake Suguru;Todo Maki;Oyama Masafumi;Ishida Mayumi
Nivolumab已成为各种部位癌症的有效治疗选择;然而，由于其作用机制，这种药物可能会引起免疫相关的不良反应。此外，很少有关于接受纳武单抗治疗的患者中的硫胺素缺乏症（TD）的报道。我们报道了一例复发性肾细胞癌患者，在开始纳武利尤单抗治疗后发生TD。在肿瘤科，他已经减轻了约4kg，并且在四个周期的纳武单抗治疗后显示出能量损失。精神科的访谈显示他精力减退。神经系统检查未发现任何意识障碍、共济失调或眼部症状。他没有出现食欲不振。一些营养素的吸收不良或过度消耗被认为是由于体重迅速减轻而发生的;因此，怀疑维生素B1的减少，维生素B1在体内的储存期很短，并且通常在癌症患者中缺乏。TD的诊断支持患者的血清硫胺素水平异常低。结果的意义在用纳武利尤单抗治疗的患者中，有必要在进行治疗时仔细注意TD。希望未来的研究可以揭示nivolumab给药与TD之间的联系。
BackgroundNivolumab has become an effective treatment option for cancer in various sites; however, this drug may cause immune-related adverse effects due to its mechanism of action. Furthermore, little has been reported on thiamine deficiency (TD) in patients receiving nivolumab treatment.MethodFrom a series of cancer patients, we reported a patient with recurrent renal cell carcinoma who developed TD after the start of nivolumab treatment.ResultsA 74-year-old man with recurrent renal cell carcinoma was referred to the psycho-oncology department as he had lost about 4 kg and displayed a loss of energy after four cycles of nivolumab treatment. Psychiatric interviews revealed a decrease in energy. Neurological examination did not reveal any impairment in consciousness, ataxia, or ocular symptoms. He did not develop appetite loss. The malabsorption or overconsumption of some nutrients is thought to occur due to the rapid loss of weight; thus, a reduction in vitamin B1, which has a short storage period in the body and is often deficient in cancer patients, was suspected. The diagnosis of TD was supported by the patient's abnormally low serum thiamine level.Significance of resultsIn patients treated with nivolumab, it is necessary to pay careful attention to TD when proceeding with the treatment. It is hoped that future research may reveal the link between nivolumab administration and TD.
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影响因子：
3.4
作者：
Isenberg-Grzeda E;Alici Y;Hatzoglou V;Nelson C;Breitbart W
通讯作者：
Breitbart W
影响因子：
8.4
作者：
AKSOY, M;BASU, TK;DICKERSON, JWT
通讯作者：
DICKERSON, JWT
影响因子：
2.2
作者：
Onishi, Hideki;Ishida, Mayumi;Akechi, Tatsuo
通讯作者：
Akechi, Tatsuo
DOI：
10.1093/geronj/46.1.m16
发表时间：
1991-01-01
期刊：
JOURNALS OF GERONTOLOGY
影响因子：
--
作者：
SMIDT, LJ;CREMIN, FM;CLIFFORD, AJ
通讯作者：
CLIFFORD, AJ
影响因子：
9
作者：
MACLEAN, LD;RHODE, BM;SHIZGAL, HM
通讯作者：
SHIZGAL, HM