Background: Radiation recall pneumonitis (RRP) is a subclinical radiation damage but relatively severe unexpected happens in previously irradiated areas of the lung tissues after administration of systemic agents. previous reports of RRP mainly associated with chemotherapy and molecular-targeted agents. RRP is caused by immunotherapy has been rarely reported. Here we describe a novel pattern RRP cases caused by anti-PD-1 blockade Camrelizumab 2 years after radiotherapy, with some focus on further understanding of this phenomenon. Case Report: A 64 years old man with lung cancer non-small cell (NSCLC) received two cycles of chemotherapy with cisplatin and pemetrexed first.
Subsequently, he underwent concurrent chemoradiotherapy with cisplatin and pemetrexed for simultaneous integrated boost (SIB) radiotherapy. After 15 months, since the development of tumors and brain metastases, it begins with the provision of anti-PD-1 blockade Camrelizumab (200 mg q2w) and stereotactic radiosurgery (SRS). Patients have fever, shortness of breath and cough after administration Camrelizumab eighth. Meanwhile, chest CT revealed patchy consolidation and ground-glass opacities in the local area previously irradiated. subsequent treatment regimens tailored to prednisolone 80 mg q12h with Camrelizumab termination.
Then the symptoms gradually subsided and the CT examination showed a significant improvement in the RRP after 2 weeks. Conclusions: Our report presents case RRP novel patterns caused by the anti-PD-1 blockade Camrelizumab 2 years after radiotherapy. This suggests that radiotherapy previously coupled with the subsequent anti-PD-1 blockade has the potential to cause an overlap of lung damage, indicates that attention is intense may be needed for patients treated with anti-PD-1 blockade in conjunction with a history of chest radiation ,
Origin of neurogenic intermittent claudication is usually caused by lumbar spinal canal stenosis. However, there are some reports of intermittent claudication caused by cervical spine compression.We present the case of a 75-year-old woman who presented with intermittent claudication. He had a history of lumbar spinal fusion surgery, but there are no signs of lumbar spinal stenosis. He also reported on the bilateral thigh pain cervical extension. Electromyogram (EMG), the posture-induced test, myelogram, and post-myelogram dynamic computed tomography (CT) is performed.
Myelography and dynamic post-myelogram CT in cervical extension position showed subarachnoid space narrowing; patient reported pain in the front of the thighs during the procedure. We perform an electromyogram (EMG), which implied neurogenic changes below the level of C5. Based on these results, we diagnosed cervical spinal cord compression and live in C4-6 laminoplasty including the dome-like laminectomy, which is significantly relieved pain thigh and allows him to run for 40 minutes
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