免疫检查点抑制剂相关输尿管膀胱炎:病例报道1例及文献复习

Immune Checkpoint Inhibitors Related Cystoureteritis:A Case Report and Literature Review

1例应用帕博利珠单抗联合化疗治疗的晚期肺腺癌患者在治疗14个周期后出现了尿频、尿急症状。经尿常规、肾功能、膀胱镜及计算机断层扫描(computed tomography,CT)检查考虑为免疫抑制剂相关性输尿管膀胱炎以及急性肾损伤。停用帕博利珠单抗联合化疗后症状缓解,再次应用帕博利珠单抗联合化疗尿路刺激症状明显加重,应用激素治疗后症状缓解。在使用免疫检查点抑制剂时,患者如出现泌尿系统症状,需考虑免疫相关输尿管膀胱炎,尽早识别和治疗。

A patient with advanced lung adenocarcinoma developed symptoms of frequent urination and urgent urination after 14 cycles of Pembrolizumab combined with chemotherapy.After making comprehensive analysis of the results of urine routine test,renal function,cystoscope and computed tomography(CT)examination,immune checkpoint inhibitors related cystoureteritis and acute kidney injury were considered.The patient’s symptoms were relieved after discontinuation of Pembrolizumab combined with chemotherapy.However,the symptoms of urinary irritation worsened significantly after rechallenging Pembrolizumab combined with chemotherapy,and the symptoms was relieved after corticosteroids treatment.If patients develop urinary symptoms during immune checkpoint inhibitors treatment,immune checkpoint inhibitors related cystoureteritis should be considered for early differential diagnosis in order to implement appropriate treatment.