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Very Delayed Acute Hepatitis after Pembrolizumab Therapy for Advanced Malignancy: How Long Should We Watch?

机译:彭布罗齐松治疗急性肝炎因晚期恶性肿瘤后急性肝炎:我们应该看多久了?

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摘要

Immune checkpoint inhibitors (ICIs) have led to major therapeutic advances in the management of malignancy. Despite promising outcomes for some cancers, ICIs are linked to unique side-effects known as immune-related adverse events (IrAEs). These may affect a wide array of organ systems. In particular, ICI-induced hepatitis is diagnostically challenging given its variable natural history and clinical manifestations. The onset of ICI-induced hepatitis often occurs between 6 and 14 weeks after treatment initiation and rarely exhibits delayed presentations or manifests after treatment cessation. We present a case of very delayed-onset ICI-induced hepatitis, stressing the importance of long-term surveillance for immune-indued hepatitis in patients initiated on ICIs even long after treatment cessation.
机译:免疫检查点抑制剂(ICIS)导致了恶性肿瘤管理的主要治疗进展。尽管某些癌症有前途的结果,但ICIS与称为免疫相关不良事件(IRAES)的独特副作用有关。这些可能会影响广泛的器官系统。特别是,鉴于其可变的自然历史和临床表现,ICI诱导的肝炎是诊断上的挑战性。 ICI诱导的肝炎的发作经常发生在治疗开始后的6至14周之间,并且在治疗停止后,很少表现出延迟呈现或表现。我们提出了一种非常延迟的ICI诱导的肝炎,强调了在治疗停止后长期在ICIS上发起的患者中长期监测的重要性肝炎。

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