BACKGROUND Camrelizumab(SHR-1210),an immune checkpoint inhibitor,is clinically used as a therapeutic option for various types of tumors.However,reports of adverse reactions associated with camrelizumab are gradually i...BACKGROUND Camrelizumab(SHR-1210),an immune checkpoint inhibitor,is clinically used as a therapeutic option for various types of tumors.However,reports of adverse reactions associated with camrelizumab are gradually increasing.Anaphylactic shock due to camrelizumab has not been reported previously,until now.We report here,for the first time,a case of anaphylactic shock associated with camrelizumab in a patient with esophageal squamous cell carcinoma.CASE SUMMARY An 84-year-old male esophageal cancer patient received radiotherapy and chemotherapy 11 years ago.He was diagnosed with advanced esophageal squamous cell carcinoma with liver metastasis(Tx N1 M1)and received the first immunotherapy(camrelizumab 200 mg/each time,once every 3 wk)dose in December 2020,with no adverse reactions.Three weeks later,a generalized rash was noted on the chest and upper limbs;palpitations and breathing difficulties with a sense of dying occurred 10 min after the patient had been administered with the second camrelizumab therapy.Electrocardiograph monitoring revealed a 70 beats/min pulse rate,69/24 mm Hg(1 mm Hg=0.133 k Pa)blood pressure,28 breaths/min respiratory rate,and 86%pulse oximetry in room air.The patient was diagnosed with anaphylactic shock and was managed with intravenous fluid,adrenaline,dexamethasone sodium phosphate,calcium glucosate,and noradrenaline.Approximately 2 h after treatment,the patient’s anaphylactic shock symptoms had been completely relieved.CONCLUSION Due to the widespread use of camrelizumab,attention should be paid to anti-programmed cell death 1 antibody therapy-associated hypersensitivity or anaphylactic shock.展开更多
BACKGROUND Atezolizumab is a programmed death ligand 1(PD-L1)inhibitor,and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma(HCC).Treatment with immu...BACKGROUND Atezolizumab is a programmed death ligand 1(PD-L1)inhibitor,and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma(HCC).Treatment with immune checkpoint inhibitors(ICIs)can lead to hypersensitivity reactions;however,anaphylactic shock is rare.We present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature review.CASE SUMMARY A 75-year-old man was diagnosed with HCC recurrence after hepatectomy.He was administered immunotherapy with atezolizumab plus bevacizumab after an allergy to a programmed death-1(PD-1)inhibitor.The patient showed a sudden onset of dizziness,numbness,and lack of consciousness with severe hypotension during atezolizumab infusion.The treatment was stopped immediately.The patient’s symptoms resolved after 5 mg dexamethasone was administered.Because of repeated hypersensitivity reactions to ICIs,treatment was changed to oral targeted regorafenib therapy.CONCLUSION Further research is necessary for elucidating the hypersensitivity mechanisms and establishing standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs.展开更多
Kounis syndrome seems to be not a rare disease but a rarely diagnosed disorder. Multiple causes can join forc-es and trigger the development of this syndrome. We report the first case of Kounis syndrome manifesting as...Kounis syndrome seems to be not a rare disease but a rarely diagnosed disorder. Multiple causes can join forc-es and trigger the development of this syndrome. We report the first case of Kounis syndrome manifesting as myocardial infarction with cardiovascular collapse that occurred in the dialysis room following an allergic reac-tion. The dialysis apparatus material of polyurethane, polyamide, polycarbonate, silicon rubber and polypro-pylene were incriminated causes. Physicians should be aware of the causality and existence of this disorder in order to achieve early and correct diagnosis and apply the appropriate therapeutic measures.展开更多
Echinococcosis is a severe helminthic zoonosis largely caused by Echinococcus granulosus and frequently encountered in endemic areas.The liver and lung are the most frequently involved organs.Cyst rupture into the per...Echinococcosis is a severe helminthic zoonosis largely caused by Echinococcus granulosus and frequently encountered in endemic areas.The liver and lung are the most frequently involved organs.Cyst rupture into the peritoneal cavity represents a rare but serious complication.Herein,we describe an acute occurrence of anaphylactic shock due to a spontaneous rupture of hydatid cyst in a 21-year-old Turkish patient unwittingly infected by Echinococcosis.Resection surgery of the perforated cyst in combination with cleaning of the abdominal cavity was performed.The patient rapidly improved and no relapse occurred during a follow-up of 8 months.Anaphylaxis is a serious complication of hydatid cyst rupture and needs to be promptly diagnosed.The main objective of our report is to underscore this life-threatening complication that should be considered when anaphylactic shock of unknown origin occurs,even in non-endemic regions.Moreover,we emphasize the need for a radical surgical approach to avoid widespread dissemination.展开更多
基金Supported by the National Natural Science Foundation of China,No.81873317the Natural Science Foundation of Zhejiang,No.LSY19H030002the Science and Technology Projects of Hangzhou City,No.20181228Y22。
文摘BACKGROUND Camrelizumab(SHR-1210),an immune checkpoint inhibitor,is clinically used as a therapeutic option for various types of tumors.However,reports of adverse reactions associated with camrelizumab are gradually increasing.Anaphylactic shock due to camrelizumab has not been reported previously,until now.We report here,for the first time,a case of anaphylactic shock associated with camrelizumab in a patient with esophageal squamous cell carcinoma.CASE SUMMARY An 84-year-old male esophageal cancer patient received radiotherapy and chemotherapy 11 years ago.He was diagnosed with advanced esophageal squamous cell carcinoma with liver metastasis(Tx N1 M1)and received the first immunotherapy(camrelizumab 200 mg/each time,once every 3 wk)dose in December 2020,with no adverse reactions.Three weeks later,a generalized rash was noted on the chest and upper limbs;palpitations and breathing difficulties with a sense of dying occurred 10 min after the patient had been administered with the second camrelizumab therapy.Electrocardiograph monitoring revealed a 70 beats/min pulse rate,69/24 mm Hg(1 mm Hg=0.133 k Pa)blood pressure,28 breaths/min respiratory rate,and 86%pulse oximetry in room air.The patient was diagnosed with anaphylactic shock and was managed with intravenous fluid,adrenaline,dexamethasone sodium phosphate,calcium glucosate,and noradrenaline.Approximately 2 h after treatment,the patient’s anaphylactic shock symptoms had been completely relieved.CONCLUSION Due to the widespread use of camrelizumab,attention should be paid to anti-programmed cell death 1 antibody therapy-associated hypersensitivity or anaphylactic shock.
基金Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,China,No.2020372769.
文摘BACKGROUND Atezolizumab is a programmed death ligand 1(PD-L1)inhibitor,and its combination with bevacizumab has been proven an effective immunotherapy for unresectable hepatocellular carcinoma(HCC).Treatment with immune checkpoint inhibitors(ICIs)can lead to hypersensitivity reactions;however,anaphylactic shock is rare.We present a case of life-threatening anaphylactic shock during atezolizumab infusion and performed a relevant literature review.CASE SUMMARY A 75-year-old man was diagnosed with HCC recurrence after hepatectomy.He was administered immunotherapy with atezolizumab plus bevacizumab after an allergy to a programmed death-1(PD-1)inhibitor.The patient showed a sudden onset of dizziness,numbness,and lack of consciousness with severe hypotension during atezolizumab infusion.The treatment was stopped immediately.The patient’s symptoms resolved after 5 mg dexamethasone was administered.Because of repeated hypersensitivity reactions to ICIs,treatment was changed to oral targeted regorafenib therapy.CONCLUSION Further research is necessary for elucidating the hypersensitivity mechanisms and establishing standardized skin test and desensitization protocols associated with PD-1 and PD-L1 to ensure effective treatment with ICIs.
文摘Kounis syndrome seems to be not a rare disease but a rarely diagnosed disorder. Multiple causes can join forc-es and trigger the development of this syndrome. We report the first case of Kounis syndrome manifesting as myocardial infarction with cardiovascular collapse that occurred in the dialysis room following an allergic reac-tion. The dialysis apparatus material of polyurethane, polyamide, polycarbonate, silicon rubber and polypro-pylene were incriminated causes. Physicians should be aware of the causality and existence of this disorder in order to achieve early and correct diagnosis and apply the appropriate therapeutic measures.
文摘Echinococcosis is a severe helminthic zoonosis largely caused by Echinococcus granulosus and frequently encountered in endemic areas.The liver and lung are the most frequently involved organs.Cyst rupture into the peritoneal cavity represents a rare but serious complication.Herein,we describe an acute occurrence of anaphylactic shock due to a spontaneous rupture of hydatid cyst in a 21-year-old Turkish patient unwittingly infected by Echinococcosis.Resection surgery of the perforated cyst in combination with cleaning of the abdominal cavity was performed.The patient rapidly improved and no relapse occurred during a follow-up of 8 months.Anaphylaxis is a serious complication of hydatid cyst rupture and needs to be promptly diagnosed.The main objective of our report is to underscore this life-threatening complication that should be considered when anaphylactic shock of unknown origin occurs,even in non-endemic regions.Moreover,we emphasize the need for a radical surgical approach to avoid widespread dissemination.
