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Immune-related pancreatitis due to anti-PD-L1 therapy in a patient with non–small cell lung cancer: A case report

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  • معلومة اضافية
    • Contributors:
      Hôpital universitaire Robert Debré Reims (CHU Reims); Centre Hospitalier de Charleville-Mezières; Service des maladies respiratoires et allergiques CHU Reims; Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL); Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
    • بيانات النشر:
      CCSD
      Lippincott, Williams & Wilkins
    • الموضوع:
      2022
    • Collection:
      Inserm: HAL (Institut national de la santé et de la recherche médicale)
    • نبذة مختصرة :
      International audience ; Rationale: Despite clinical-proven benefits of immune checkpoint inhibitors (ICIs) on advanced lung cancer, rare but life-threatening immune-related adverse events (irAEs) have been reported. Pancreatitis is a rare irAE that can occur with any ICI.Patient concerns: A 53-year-old man with locally advanced non–small cell lung carcinoma was treated with radiochemotherapy and then durvalumab (anti–programmed cell death ligand 1 therapy). Twelve weeks after the beginning of ICI, he reported abdominal pain and anorexia. Blood test showed high level of lipase. Abdominal computed tomography revealed a swollen pancreas. These findings were confirmed by magnetic resonance cholangiopancreatography and biliopancreatic endoscopic ultrasonography.Diagnoses: Grade IV immune-related pancreatitis.Interventions: The patient was treated with corticosteroid therapy, resulting in clinical, radiological, and biological improvement.Outcomes: During the first month, corticosteroid therapy could not be decreased under 1 mg/kg/d because of symptoms recurrence and lipasemia rerising. Four months after this episode, the patient died from acute ischemia of the lower limbs while he was on <20 mg/d of corticosteroid.Lessons: To the best of our knowledge, immune-related pancreatitis has been reported only with anti–programmed cell death 1 or anti–cytotoxic T lymphocyte antigen 4 therapies but never with anti–programmed cell death ligand 1 therapy. It is important to report such rare cases to improve diagnosis and management of irAEs.
    • الرقم المعرف:
      10.1097/MD.0000000000029612
    • الدخول الالكتروني :
      https://hal.univ-reims.fr/hal-03800193
      https://hal.univ-reims.fr/hal-03800193v1/document
      https://hal.univ-reims.fr/hal-03800193v1/file/JulieMalet_Medicine_2022.pdf
      https://doi.org/10.1097/MD.0000000000029612
    • Rights:
      http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.8500AF75