帕博利珠单抗致甲状腺功能减退

Hypothyroidism induced by pembrolizumab

1例73岁男性患者,因“咳嗽咳痰半个月,剧烈时伴上腹部疼痛,疼痛放射至背部”入院。入院后诊断为右肺鳞癌。给予卡铂注射液(580mg,qd,ivgtt)、注射用紫杉醇(白蛋白结合型,400mg,qd,ivgtt)联合帕博利珠单抗注射液(200mg,q 3w,ivgtt)进行治疗。患者在应用帕博利珠单抗6次后,出现甲状腺功能减退,临床药师对帕博利珠单抗致甲状腺功能减退的不良反应进行密切监护,建议医师给予口服左甲状腺素钠片对症治疗,对患者进行用药教育并根据甲状腺功能情况对药物剂量进行调整。患者连续服用左甲状腺素钠片3个疗程后,甲状腺功能恢复正常。

A 73-year-old male patient was admitted to the hospital due to cough and expectoration for half a month,when severe with epigastric pain radiating to the back and diagnosed with squamous cell carcinoma of the right lung after admission.Carboplatin injection(580 mg,qd,ivgtt),paclitaxel for injection(albumin-bound type,400 mg,qd,ivgtt)and pembrolizumab injection(200 mg,q 3 w,ivgtt)were given to him.And he developed hypothyroidism after the 6 times of pembrolizumab injection.Clinical pharmacists focused on closely monitoring of hypothyroidism caused by pembrolizumab,suggested giving him oral levothyroxine sodium tablets,giving medication education to patient and adjusted the drug dose according to the thyroid function.After 3 courses of levothyroxine sodium tablets,his thyroid function gradually returned to normal.