摘要
1例53岁女性患者于肝内胆管癌术后20个月给予纳武利尤单抗注射液140 mg静脉滴注、1次/d,第1、20天。第2次应用该药后第3天,患者出现双下肢乏力;第14天乏力加重,出现视物模糊、上眼睑下垂、胸闷气促伴心悸;第24天出现胡言乱语,发展为呼之不应。给予气管插管机械通气及对症支持治疗后患者神志恢复。诊断为药源性重症肌无力危象,合并心力衰竭、呼吸衰竭。给予激素、人免疫球蛋白治疗19 d后,患者眼睑下垂、心悸症状明显好转,但呼吸衰竭无明显好转,无法脱机自主呼吸。
A 53-year-old female patient received an IV infusion of nivolumab 140 mg once daily 20 months after the operation of intrahepatic cholangiocarcinomas.The drug was used on the first and 20th days of the treatment.On day 3 of the second injection of the drug,the patient developed weakness in both lower limbs,which was aggravated on day 14,accompanied by symptoms such as burred vision,ptosis,chest tightness,short of breath,and palpitation.On day 24 of the second injection of the drug,her condition became worse,the patient raved,then developed no response to voice stimuli.The patient's conscious-ness recovered after mechanical ventilation with nasotracheal intubation and symptomatic and supportive treatments.The patient was diagnosed as drug-induced myasthenia gravis crisis combined with heart failure and respiratory failure.After 19 days of treatments with hormone and human immune globulin,her ptosis and pal-pitation were improved.However,her respiratory failure was not improved.She was unable to breathe sponta-neously.
作者
段曼
李兴花
唐晓霞
Duan Man;Li Xinghua;Tang Xiaoxia(Department of Clinical Pharmacy,Xiaogan Hospial Ailited to Wuhan University of Science and Technology,Hubei Prorince,Xiaogan 432000,China;Department of Gynecology,Maoshan Health Center,Jiangshan Town,Yinzhou District,Zhejiang Province,Ningbo 315193,China)
出处
《药物不良反应杂志》
CSCD
2020年第2期109-110,共2页
Adverse Drug Reactions Journal
基金
宁波市自然科学基金(2017A610254)。
