Tumor lysis syndrome in a patient with metastatic melanoma treated with nivolumab
Tumor lysis syndrome in a patient with metastatic melanoma treated with nivolumab
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接受纳武单抗治疗的转移性黑色素瘤患者的肿瘤溶解综合征
DOI：
10.1007/s12328-020-01164-x
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发表时间：
2020
影响因子：
1
通讯作者：
Honda
中科院分区：
文献类型：
--
作者：
Sugimoto Saiho;Terashima Takeshi;Yamashita Tatsuya;Iida Noriho;Kitahara Masaaki;Hodo Yuji;Shimakami Tetsuro;Takatori Hajime;Arai Kuniaki;Kawaguchi Kazunori;Kitamura Kazuya;Yamashita Taro;Sakai Yoshio;Shirota Yukihiro;Sato Katsuaki;Mizukoshi Eishiro;Honda
一名患有右上颌窦转移性黑色素瘤和多发性肝转移的79岁男性接受了单剂量的纳武利尤单抗。8天后，他出现意识受损，伴有异常实验室检查和心电图检查结果。因此，他被诊断为肿瘤溶解综合征（TLS）。实验室和心电图结果在连续血液透析滤过后立即改善;然而，他在接受纳武利尤单抗治疗后22天死亡。尸检显示肝脏有大量肿瘤坏死。很少有与免疫检查点抑制剂相关的TLS病例报告，这表明我们应该做好准备，特别是在肝脏受累的高肿瘤负荷患者中。
A 79-year-old man with metastatic melanoma of the right maxillary sinus and multiple liver metastases received a single dose of nivolumab. Eight days later, he experienced impaired consciousness, accompanied by abnormal laboratory and electrocardiographic findings. He was therefore diagnosed with tumor lysis syndrome (TLS). Laboratory and electrocardiographic findings improved immediately after continuous hemodiafiltration; however, he died 22 days after receiving nivolumab. Autopsy revealed massive tumor necrosis in the liver. There are few case reports of TLS associated with immune checkpoint inhibitors, indicating that we should be prepared to manage especially in a patient with liver involvement of high tumor burden.