Редкие иммуноопосредованные нежелательные явления. Клинический случай синдрома Шегрена на фоне иммунотерапии у пациента с аденокарциномой легкого

Abstract

Given the rapid expansion of indications for immune checkpoint inhibitors therapy in the clinical practice of oncologists, as well as the emergence of new drugs with similar mechanisms of action, knowledge of rare immune-related adverse events is extremely important for physicians, both in terms of their early detection and optimisation of treatment tactics. Despite their rarity, the spectrum of rheumatological manifestations is quite broad, which requires the continued detailed accumulation and analysis of clinical material. The present clinical observation convincingly demonstrates that when prescribing immune checkpoint inhibitors in case of symptoms suspicious of Sjögren's syndrome, a thorough history and a complete examination, including specialized diagnostic tests to evaluate salivary and lacrimal gland function, should be performed. The differential diagnosis of Sjögren's syndrome with other nosologies requires serum autoantibody testing and salivary gland biopsy. Prompt referral of the patient to a rheumatologist is critical, to avoid delay in making a correct diagnosis. Early diagnosis and timely treatment of toxic reactions are the key to successful anti-tumour therapy. Achieving this goal requires close collaboration between multidisciplinary physicians, the patient, and the patient's family.