IgA vasculitis induced by tislelizumab
10.3760/cma.j.cn114015-20240731-00660
- VernacularTitle:替雷利珠单抗致免疫球蛋白A血管炎
- Author:
Kexin WANG
1
;
Bao SUN
;
Zhiying LUO
;
Suyun QUE
;
Bikui ZHANG
;
Wenhui LIU
Author Information
1. 广州中医药大学附属中山中医院药学部，中山 528400
- Publication Type:Journal Article
- Keywords:
Purpura, Schoenlein-Henoch;
Immune checkpoint inhibitors;
IgA vasculitis;
Tislelizumab;
Immune-related adverse events
- From:
Adverse Drug Reactions Journal
2025;27(4):253-256
- CountryChina
- Language:Chinese
-
Abstract:
A 55-year-old male patient received immunotherapy combined with chemotherapy regimen(intravenous infusions of tislelizumab 200 mg on day 1, paclitaxel protein-bound 470 mg, and carboplatin 500 mg on day 1) after surgery for left upper lung squamous cell carcinoma, with 21 days as a treatment cycle. After more than half a month of medication in the 1st cycle, the patient developed multiple symmetrical purple red bruises on both lower limbs, which did not fade when pressed. The purple red bruising disappeared the next day after treatment with anti-allergic drugs. After 3 days of medication in the 3rd cycle, the patient developed a large number of scattered red papules on both lower limbs, protruding from the surface of the skin and accompanied by itching, a small number of red papules were scattered on both upper limbs and the face; after 15 days, the patient felt poor appetite; after 16 days, the patient experienced abdominal pain accompanied by vomiting and loose yellow stool. Laboratory tests showed a blood creatinine level of 204 μmol/L and occult blood in urine (+++). Pathological examination of skin tissue at the lesion site of the patient suggested IgA vasculitis (IgAV). After excluding other factors such as primary disease and infection, it was considered that the IgAV was probably related to tislelizumab. Tislelizumab was discontinued, anti-allergic and anti-inflammatory drugs, and glucocorticoid were given. After 2 weeks of treatments, the skin purpura gradually disappeared, and the abdominal pain and renal function indicators were improved. After fully aware of the risks, the patient was restarted tislelizumab immunotherapy combined with chemotherapy, and anti-allergic drugs were add at the same time. IgVA did not recur.
