卡瑞利珠单抗致反应性毛细血管增生症

Reactive cutaneous capillary endothelial proliferation caused by camrelizumab

1例57岁男性患者因肺腺癌给予培美曲塞+卡铂化疗(第1天)联合卡瑞利珠单抗(第2天)免疫治疗,21 d为1个周期。第2、3周期给药后患者均出现丙氨酸转氨酶升高,考虑为化疗所致,停止化疗,仅行免疫治疗。第4次免疫治疗后患者面部、颈部、背部出现血管痣,大小不等(0.1~1.2 cm),红色或红黑相间,高出皮肤表面。考虑为卡瑞利珠单抗导致的反应性毛细血管增生症。因病情需要,继续予免疫治疗。择期予手术切除较大血管痣并加用贝伐珠单抗抑制血管生成。随访6个月,切除部位血管痣未再出现,但其他部位仍有新的血管痣出现。

A 57⁃year⁃old male patient was given pemetrexed and carboplatin chemotherapy(on day 1)combined with camrelizumab(on day 2)immunotherapy for lung adenocarcinoma,21 days for a cycle.The patient developed elevated alanine aminotransferase after medication in the 2nd and 3rd cycle,which was considered to be caused by chemotherapy.Then the chemotherapy was stopped and only immunotherapy was continued.After the 4th immunotherapy,vascular nevus appeared on the patient′s face,neck,and back,ranging in different sizes(0.1-1.2 cm),red or red and black,and higher than the skin surface.It was considered to be the reactive cutaneous capillary endothelial proliferation caused by camrelizumab.Due to patient′s condition,immunotherapy was continued.Vascular nevus with larger size was surgically removed and bevacizumab was added to prevent angiogenesis.At 6⁃month of follow⁃up,the vascular nevus was found not at the excision site but in other parts.