Necrólise epidérmica tóxica associada ao uso de nivolumabe: um relato de caso

RESUMO

Imunoterapia com nivolumabe para o tratamento de segunda linha para câncer de pulmão avançado demonstrou menor toxicidade e melhores desfechos, em comparação com quimioterapia. Quando ocorrem, os eventos adversos são geralmente imuno-mediados, podendo acometer qualquer órgão e, na maioria das vezes são manejáveis, entretanto raros casos podem ser fatais. Há poucos relatos na literatura de necrólise epidérmica tóxica ocasionada por nivolumabe. O objetivo do presente relato de caso é descrever a história clínica de uma paciente que desenvolveu esta reação após uso desta medicação e discorrer uma breve revisão da literatura sobre sua etiologia e medidas terapêuticas, tendo em vista sua raridade e gravidade. São parte essencial do sucesso do tratamento a detecção precoce dos sintomas/sinais e rápido manejo dos mesmos.

ABSTRACT

Immunotherapy with nivolumab for second-line treatment for advanced lung cancer demonstrated lower toxicity and better outcomes compared to chemotherapy. When they occur, adverse events are usually immune-related, can occur in any organ, and most of the time they are manageable, although, in rare cases can be fatal. There are few reports in the literature of toxic epidermal necrolysis caused by nivolumab. The aim of the present case report is to describe the clinical history of a patient who developed this reaction after using this medication and to discuss a brief review of the literature on its etiology and therapeutic measures, considering its rarity and severity. Early detection of the symptoms/signs and their rapid management are an essential part of the treatment success.

Keywords:

Immunotherapy - Nivolumab - Lung neoplasms - Stevens-Johnson Syndrome

Descritores:

Immunoterapia - Nivolumabe - Neoplasias pulmonares - Síndrome de Stevens-Johnson

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