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JAMA Neurol:免疫检查点抑制剂相关脑炎特征研究

2021-03-17 MedSci原创 MedSci原创

免疫检查点抑制剂相关脑炎主要有2类--局灶性综合征和脑膜脑炎,多数患者的预后良好

免疫检查点抑制剂(ICIS)已成为许多肿瘤的一线治疗手段,其广泛使用的同时也导致了众多免疫相关不良事件。 据统计,2%-6%的ICIS使用者,报告了广泛的神经不良事件,包括外周和中枢神经系统不良事件,其中ICI相关的脑炎(ICI-iE)是一种罕见并发症,在任何ICI类药物中均有报道。ICI相关的脑炎是一种排除诊断,需要排除传染性、毒性或代谢原因。
近日研究人员开展系统综述研究,评估ICI-iE临床表现及其识别特征
本次研究,回顾了77篇已发表论文和1个医疗中心的5篇医疗记录,以评估ICI-iE表现形式与其预后之间的关系。时间跨度从2000年6月至2020年4月17日,收集ICIS诱导的自身免疫性病因特征的脑炎患者信息,提取有关临床、脑脊液和神经成像(磁共振成像)特征信息,以及治疗信息。
 
总计收集了82名患者信息,其中男性52人,平均年龄61.0岁。多数患者的症状为局灶性综合征(39例,48%)或脑膜脑炎(36例,44%),7名患者(9%)为不可分类的ICI-iE。23名局灶性综合征患者以及1名不可分类的ICI-iE患者检测到了神经元自身抗体,大多数为同源抗体(17例,71%),针对细胞内抗原。无局灶综合征或自身抗体阴性局灶综合征患者的预后良好(49/55,89%)。对于自身抗体阳性人群,对抗谷氨酸脱羧酶或抗细胞表面治疗有应答者,预后良好(100%)。其他自身抗体阳性患者的预后较差(17/24,71%)。抗神经自身抗体、局灶性综合征以及磁共振成像异常与不良预后相关,相反,发烧和脑脊液炎性变化与预后良好相关
免疫检查点抑制剂相关脑炎主要有2类--局灶性综合征和脑膜脑炎,多数患者的预后良好
 
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    2021-03-18 yinhl1978
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    2021-08-31 jklm09
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    2021-03-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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