内容紹介
Summary
A 67—year—old man diagnosed with clinical Stage Ⅳ gastric cancer was administered nivolumab as fourth—line chemotherapy. After 9 courses, he was emergently admitted with complaints of low blood pressure and general malaise. On the fourth hospital day, he had high—grade fever and elevated serum C—reactive protein. Computed tomography showed a moderate amount of pericardial effusion. He was administered 1.7 mg/kg of methylprednisolone and improved rapidly. A hormonal blood examination showed his adrenal gland disorder. This is the first case in our country of pericardial effusion as an immune—reactive adverse event, which is not well known in Japan.
要旨
症例は67歳,男性。術後再発胃癌に対して,四次治療としてニボルマブ単剤療法を開始した。9コース施行後に体重減少,全身倦怠感を主訴に緊急入院となった。入院後高熱とCRPの上昇を認め,胸部CTで中等量の心囊液を認めたが,メチルプレドニゾロン投与により速やかに軽快した。また,本例は副腎不全を併発していた。過去に免疫関連有害事象(immune—related adverse events:irAE)による心囊液貯留の国内での論文報告はなく認知度が低いため,念頭に置いておくべきirAEの一つとして報告する。
目次
A 67—year—old man diagnosed with clinical Stage Ⅳ gastric cancer was administered nivolumab as fourth—line chemotherapy. After 9 courses, he was emergently admitted with complaints of low blood pressure and general malaise. On the fourth hospital day, he had high—grade fever and elevated serum C—reactive protein. Computed tomography showed a moderate amount of pericardial effusion. He was administered 1.7 mg/kg of methylprednisolone and improved rapidly. A hormonal blood examination showed his adrenal gland disorder. This is the first case in our country of pericardial effusion as an immune—reactive adverse event, which is not well known in Japan.
要旨
症例は67歳,男性。術後再発胃癌に対して,四次治療としてニボルマブ単剤療法を開始した。9コース施行後に体重減少,全身倦怠感を主訴に緊急入院となった。入院後高熱とCRPの上昇を認め,胸部CTで中等量の心囊液を認めたが,メチルプレドニゾロン投与により速やかに軽快した。また,本例は副腎不全を併発していた。過去に免疫関連有害事象(immune—related adverse events:irAE)による心囊液貯留の国内での論文報告はなく認知度が低いため,念頭に置いておくべきirAEの一つとして報告する。