信迪利单抗致中毒性表皮坏死松解症1例及处理对策

Toxic epidermal necrolysis caused by sintilimab in one case and its management

目的探讨免疫检查点抑制剂(Immune checkpoint inhibitor,ICIs)信迪利单抗致中毒性表皮坏死松解症的临床表现、发病机制以及有效的治疗方案。方法通过分析1例信迪利单抗致中毒性表皮坏死松解症的病例,结合文献资料和临床指南,对其发病机制进行讨论,并提出有效的治疗建议。结果停用信迪利单抗并给予糖皮质激素、静脉注射人免疫球蛋白和血液灌流等措施后,患者皮肤得到了显著的新生和愈合。结论信迪利单抗致中毒性表皮坏死松解症需早发现早治疗,足量使用激素,配合人免疫球蛋白或血液灌流,总体预后良好。

Objective To study the clinical features,pathogenesis,and treatment regimen of toxic epidermal necrolysis caused by immune checkpoint inhibitor(ICIs)sintilimab.Methods The adverse reactions of one case of toxic epidermal necrolysis caused by sintilimab were evaluated,and the possible mechanism and proposed countermeasures was analyzed by reviewing the literature and clinical guidelines.Results The epidermis of the patients was newly healed after the withdrawal of sintilimab,using glucocorticoid,intravenous injection human immunoglobulin and hemoperfusion.Conclusion Toxic epidermal necrolysis caused by sintilimab requires early detection and treatment,sufficient glucocorticoids and human immunoglobulin or hemoperfusion,which will lead to a good overall prognosis.