替雷利珠单抗致免疫相关性肾损伤病例分析1例

One Case of Tislelizumab-Induced Immune Related Kidney Injury

目的探讨替雷利珠单抗治疗膀胱尿路上皮癌患者致免疫相关性肾损伤的处置措施。方法分析1例替雷利珠单抗致免疫相关性肾损伤患者的诊疗经过,结合文献探讨免疫相关性肾损伤的发生机制、一般特点及治疗方法。结果患者应用替雷利珠单抗单药维持治疗7-8周后血清肌酐升高,最高为247μmol/L,立即停用替雷利珠单抗,给予补液、利尿及激素治疗后,血肌酐降至78μmol/L。结论替雷利珠单抗导致免疫相关性肾损伤后,应立即停药,给予对症治疗,根据免疫相关性肾损伤的程度,应及时给予激素治疗。

Objective This study amed to explore the treatment of immune-related renal injury induced by tislelizumab in patients with bladder urothelial carcinoma.Methods We analyzed the treatment process of 1 case tislelizumab-induced immune related kidney injury.We explored the possible pathogenesis,features and treatment of immune related kidney injury in context of the literature review.Results After 7-8 weeks of maintenance treatment with tislelizumab,serum creatinine increased to a maximum of 247 μmol/L.Tislelizumab were withdrawn and the patient was gave sufficient rehydration,diuretic and glucocorticoid therapy.Ihe seium creatinine decreased to 78μmol/L.Conclusion After immune-related kidney injury caused by tislelizumab,the drug should be stopped immediately and symptomatic treatment should be given.Glucocorticoid therapy should be given in time according to the degree of immune-related kidney injury.