ペムブロリズマブによるステロイド抵抗性の薬剤性腸炎を来した症例

A case of steroid-resistant drug induced enteritis after pembrolizumab which required infliximab

　65歳男性．筋層浸潤性膀胱癌cT2N0M0にて（ゲムシタビン＋シスプラチン療法2コース）施行後，根治的膀胱全摘術＋回腸導管造設術を施行した．術後7か月の時点で肺に再発病変，術後10か月には胸骨転移，左腋窩皮下転移，縦隔・右肺門部リンパ節転移を認めた．ペムブロリズマブ2コース投与後，下痢や食欲不振，水溶性下痢便を認め，下部消化管内視鏡検査やCT検査にて薬剤性大腸炎と診断．ステロイド投与するも改善乏しく，インフリキシマブ導入にて改善を認めた．

Abstract

Sixty-five year old man, he suffered from muscular invasive bladder cancer, radical cystectomy has done. After operation within 1 year, multiple metastases has occurred. After two courses of Pembrolizumab, he suffered from diarrhea and anorexia. He diagnosed drug-induced enterocolitis by endoscopy and computed tomography. He didn't improve by steroid, but improved by Infliximab. (Rinsho Hinyokika 76 : 159-163, 2022).