RESUMO
Immune checkpoint inhibitors are the most important new medications in oncology and include inhibitors of programmed cell death protein-1 (PD-1) such as Pembrolizumab, Nivolumab, and Cemiplimab. These anticancer agents prevent tumour immune evasion and have been associated with a range of immune-related adverse events (irAEs) including those involving the nervous system. In this case report and literature review, we present the first case of inflammatory myeloradiculitis secondary to Pembrolizumab. We also summarise the characteristics, treatment, and outcomes of other cases reported in the literature which include a component of myelitis. Finally, we make general recommendations on management.
Assuntos
Antineoplásicos/efeitos adversos , Neoplasias Ósseas/secundário , Neoplasias da Mama/terapia , Everolimo/efeitos adversos , Quadril/patologia , Nefropatias/induzido quimicamente , Túbulos Renais Proximais/efeitos dos fármacos , Antineoplásicos/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias da Mama/patologia , Quimiorradioterapia/métodos , Everolimo/uso terapêutico , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Tamoxifeno/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVE: To estimate the current incidence of serious injuries in Queensland surf lifesavers related to inflatable rescue boat (IRB) use, and to describe the nature of the injuries. DESIGN: Descriptive study. PARTICIPANTS AND SETTING: The 3050 members of Queensland's 57 surf life saving clubs who drove or crewed an IRB in Queensland between July 1997 and June 1998. MAIN OUTCOME MEASURES: Incidence of serious IRB-related injuries that resulted in claims for workers compensation in 1997-1998, and type and anatomical location of injury. RESULTS: Thirty-six IRB-related injuries were lodged with WorkCover Queensland by surf lifesavers during 1997-1998, giving an estimated crude incidence of 1.2%. Sixty-one per cent of injuries affected the right side of the body; two-thirds of these involved the knee, leg and ankle. IRB injuries occurred most often during patrol duty (39% of cases) and it was usually the crewperson (86% of cases) who was injured. Fracture and fracture-dislocations constituted a third of the injuries, with 75% occurring in the right leg and ankle. CONCLUSIONS: Despite the known incomplete reporting of these injuries, our findings suggest that IRB-related injury caused substantial morbidity among volunteer surf lifesavers. The pattern of injuries suggests biomechanically preventable causes.
