中国药物警戒 ›› 2026, Vol. 23 ›› Issue (4): 464-466.
DOI: 10.19803/j.1672-8629.20240961

• 安全与合理用药 • 上一篇    下一篇

帕博利珠单抗注射液致免疫性心肌炎合并重症肌无力1例分析

陈亚丽1, 郑小春2,*   

  1. 1西宁市第一人民医院静配中心,青海 西宁 810000;
    2浙江省人民医院,杭州医学院附属人民医院药学部,浙江 杭州 310014
  • 收稿日期:2024-12-05 出版日期:2026-04-15 发布日期:2026-04-15
  • 通讯作者: *郑小春,女,硕士,副主任药师,临床药学。E-mail: 13868109173@126.com
  • 作者简介:陈亚丽,女,硕士,主管药师,临床药学。

One Case of Immune Myocarditis Complicated with Severe Myasthenia Gravis Caused by Pembrolizumab Injection

CHEN Yali1, ZHENG Xiaochun2,*   

  1. 1Department of Clinical Pharmacy, the First People’ s Hospital of Xining, Xining Qinghai 810000, China;
    2Department of Pharmacy, Zhejiang Provincial People’ s Hospital, the People’ s Hospital of Hangzhou Medical College, Hangzhou Zhejiang 310014, China;
  • Received:2024-12-05 Online:2026-04-15 Published:2026-04-15

摘要: 目的 探讨帕博利珠单抗注射液(以下简称“帕博利珠单抗”)致免疫性心肌炎合并重症肌无力的病例,为临床使用帕博利珠单抗提供参考。方法 分析1例患者因肺癌使用帕博利珠单抗出现免疫性心肌炎合并重症肌无力的诊疗过程。检索文献报道,讨论是否重启免疫检查点抑制剂治疗和临床应对策略。结果 患者使用帕博利珠单抗6周后出现免疫性心肌炎合并重症肌无力,停用帕博利珠单抗并积极对症治疗后,心肌肌钙蛋白Ⅰ明显下降,眼部肌无力症状好转。结合相关文献分析,使用帕博利珠单抗后,可能出现免疫性心肌炎合并重症肌无力,需及时停药并尽快干预。结论 帕博利珠单抗很可能导致患者出现免疫性心肌炎合并重症肌无力,临床治疗过程中应该予以重视。

关键词: 帕博利珠单抗, 免疫检查点抑制剂, 免疫性心肌炎, 重症肌无力, 药品不良反应, 肺癌

Abstract: Objective To explore one case of immune myocarditis complicated with myasthenia gravis caused by pabolizumab Injection so as to provide a reference for rational use of pabolizumab in clinic. Methods The diagnosis and treatment of one patient with autoimmune myocarditis complicated with myasthenia gravis due to lung adenocarcinoma and treated with pabolizumab were analyzed. Related literature was searched for to find out whether ICIs treatment could be restarted and what was the best coping strategy. Results The patient developed immune myocarditis complicated with myasthenia gravis about 6 weeks after pabolizumab was taken. After discontinuation of this drug and symptomatic treatment, cardiac troponin I decreased significantly and the symptoms of ocular myasthenia improved. It was found that immune myocarditis complicated with myasthenia gravis might occur following the use of pabolizumab, making it necessary to stop taking the drug and intervene as soon as possible. Conclusion Pabolizumab may lead to immune myocarditis complicated with myasthenia gravis, which deserves more attention.

Key words: Pembrolizumab Injection, Immune Checkpoint Inhibitors, Immune Myocarditis, Myasthenia Gravis, Adverse Drug Reaction, Lung Cancer

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