中国药物警戒 ›› 2025, Vol. 22 ›› Issue (8): 947-949.
DOI: 10.19803/j.1672-8629.20240869

• 安全与合理用药 • 上一篇    下一篇

信迪利单抗致内分泌系统不良反应1例分析

杨欣, 杨宝春, 杨漾, 邵欢*   

  1. 无锡市第二人民医院药学部,江苏 无锡 214002
  • 收稿日期:2024-11-08 出版日期:2025-08-15 发布日期:2025-08-13
  • 通讯作者: *邵欢,女,主任药师,硕士,药事管理。E-mail: 12048984@qq.com
  • 作者简介:杨欣,女,副主任药师,硕士,临床药学。
  • 基金资助:
    江苏省药学会-奥赛康临床药学基金科研项目（A201824）

One Case of Multiple Endocrine Adverse Effect Caused by Sintilimab

YANG Xin, YANG Baochun, YANG Yang, SHAO Huan*   

  1. Department of Pharmacy, No.2. People’s Hospital of Wuxi, Wuxi Jiangsu 214002, China
  • Received:2024-11-08 Online:2025-08-15 Published:2025-08-13

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摘要： 目的 探讨信迪利单抗致内分泌腺功能异常的临床特征及处理方法,为临床用药提供参考。方法 分析1例胃癌患者接受信迪利单抗治疗后相继出现孤立性促肾上腺皮质激素缺乏症和原发性甲状腺功能减退的内分泌系统不良反应病例,并结合文献进行讨论。结果 根据临床症状、实验室检查、用药时间相关性,判定内分泌系统不良反应很可能是信迪利单抗所致,停用信迪利单抗并予泼尼松和左甲状腺素替代治疗后,患者临床症状完全缓解,重启免疫治疗。结论 信迪利单抗治疗期间应警惕内分泌系统不良反应,尤其当患者出现低钠、乏力时,一旦发生可能需要终身激素替代治疗,基线检查和定期复查有助于早期发现相关不良反应,避免出现严重后果。

关键词: 信迪利单抗, 孤立性促肾上腺皮质激素缺乏症, 原发性甲状腺功能减退, 泼尼松, 左甲状腺素, 药品不良反应

Abstract: Objective To investigate the clinical characteristics and management of endocrine dysfunction induced by sintilimab. Methods One case of gastric cancer who developed isolated adrenocorticotropic hormone deficiency and primary hypothyroidism after sintilimab treatment was reported while related literature was reviewed. Results The endocrine adverse reactions were strongly associated with sintilimab based on clinical manifestations, laboratory findings, and temporal relationship. After discontinuation of sintilimab and initiation of prednisone and levothyroxine replacement therapy, the patient’s symptoms were resolved completely, allowing for immunotherapy resumption. Conclusion Patients receiving sintilimab should be monitored for endocrine adverse reactions (e.g., hyponatremia and fatigue), in case of which lifelong hormone replacement is required. Baseline assessment and regular endocrine function monitoring are crucial to early detection and prevention of serious outcomes.

Key words: Sintilimab, Isolated Adrenocorticotropic Hormone Deficiency, Primary Hypothyroidism, Prednisone, Levothyroxine, Adverse Drug Reactions

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