Sintilimab-induced multiple organ immune-related adverse reactions
10.3760/cma.j.cn114015-20221212-01145
- VernacularTitle:信迪利单抗致多器官免疫相关不良反应
- Author:
Ning LI
1
;
Jinghui ZHAI
;
Weiqiang CHEN
;
Jie WANG
;
Yuanyuan WANG
;
Yanxue LIU
;
Yanqing SONG
Author Information
1. 吉林大学第一医院临床药学部，长春 130000
- Publication Type:Journal Article
- Keywords:
Antineoplastic agents, immunological;
Immune-related liver injury;
Immunerelated myositis;
Immune-related cardiotoxicity;
Sintilimab;
Immune checkpoint inh
- From:
Adverse Drug Reactions Journal
2024;26(2):118-120
- CountryChina
- Language:Chinese
-
Abstract:
A 67-year-old male patient with primary liver cancer was given combination treatment with regorafenib and sintilimab because of disease progression after multiple interventional therapy. After one cycle of medication, the patient developed weakness in the left facial expression muscle and left upper eyelid, and generalized muscle pain with dyspnea. Laboratory tests showed myoglobin 8 614 μg/L, creatine kinase (CK) 17 480 U/L, CK-MB mass 528 μg/L, troponin I 0.465 μg/L, aspartate aminotransferase (AST) 1 069 U/L, alanine aminotransferase (ALT) 493 U/L, and lactate dehydrogenase (LDH) 2 469 U/L. The electrocardiogram showed the new onset of left bundle branch block. It was considered to be immune-related myositis, immune-related myalgia, and immune-related hepatitis caused by sintilimab, not excluding immune-related cardiac toxicity. Regorafenib and sintilimab were discontinued immediately while methylprednisolone pulse therapy was initiated at a dose of 500 mg (gradually reduced after 5 days), monoammonium glycyrrhizinate and cysteine and sodium chloride injection and bicyclol were administered for liver protection and reducing liver enzyme levels. After 7 days of treatments, weakness in the left facial expression muscle and eyelid were improved significantly along with relief from chest tightness and alleviation of generalized muscle pain throughout the body. After 15 days of treatments, laboratory tests showed myoglobin 494 μg/L, CK 537 U/L, CK-MB mass 115 μg/L, AST 52 U/L, ALT 77 U/L, and LDH 519 U/L. After half a year of treatments, glucocorticoids therapy was discontinued, and all indicators returned basically to normal. The patient did not receive immunotherapy again.
