Liu K, Bao JF, Wang T, Yang H, Xu BP. Camrelizumab-induced anaphylactic shock in an esophageal squamous cell carcinoma patient: A case report and review of literature. World J Clin Cases 2022; 10(18): 6198-6204 [PMID: 35949858 DOI: 10.12998/wjcc.v10.i18.6198]
Corresponding Author of This Article
Bao-Ping Xu, MD, Professor, Department of Critical Care Medicine, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, No. 76 Renmin Road, Lu’an 237000, Anhui Province, China. xu131406@qq.com
Research Domain of This Article
Allergy
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 26, 2022; 10(18): 6198-6204 Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6198
Camrelizumab-induced anaphylactic shock in an esophageal squamous cell carcinoma patient: A case report and review of literature
Kai Liu, Jian-Feng Bao, Tao Wang, Hao Yang, Bao-Ping Xu
Kai Liu, Department of Radiotherapy, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
Jian-Feng Bao, Department of Immunology, Xixi Hospital of Hangzhou affiliated to Zhejiang University of Traditional Chinese Medicine, Hangzhou 310023, Zhejiang Province, China
Tao Wang, Department of Urology, Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine, Zhongshan 528401, Guangdong Province, China
Hao Yang, Bao-Ping Xu, Department of Critical Care Medicine, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
Author contributions: Xu BP and Liu K designed the study and drafted the manuscript; Wang T and Yang H collected and analyzed the data; Xu BP and Bao JF revised the manuscript critically for important intellectual content; all authors reviewed and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 81873317; the Natural Science Foundation of Zhejiang, No. LSY19H030002; and the Science and Technology Projects of Hangzhou City, No. 20181228Y22.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Ping Xu, MD, Professor, Department of Critical Care Medicine, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, No. 76 Renmin Road, Lu’an 237000, Anhui Province, China. xu131406@qq.com
Received: November 9, 2021 Peer-review started: November 9, 2021 First decision: December 27, 2021 Revised: January 13, 2022 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: June 26, 2022 Processing time: 219 Days and 14.1 Hours
Abstract
BACKGROUND
Camrelizumab (SHR-1210), an immune checkpoint inhibitor, is clinically used as a therapeutic option for various types of tumors. However, reports of adverse reactions associated with camrelizumab are gradually increasing. Anaphylactic shock due to camrelizumab has not been reported previously, until now. We report here, for the first time, a case of anaphylactic shock associated with camrelizumab in a patient with esophageal squamous cell carcinoma.
CASE SUMMARY
An 84-year-old male esophageal cancer patient received radiotherapy and chemotherapy 11 years ago. He was diagnosed with advanced esophageal squamous cell carcinoma with liver metastasis (TxN1M1) and received the first immunotherapy (camrelizumab 200 mg/each time, once every 3 wk) dose in December 2020, with no adverse reactions. Three weeks later, a generalized rash was noted on the chest and upper limbs; palpitations and breathing difficulties with a sense of dying occurred 10 min after the patient had been administered with the second camrelizumab therapy. Electrocardiograph monitoring revealed a 70 beats/min pulse rate, 69/24 mmHg (1 mmHg = 0.133 kPa) blood pressure, 28 breaths/min respiratory rate, and 86% pulse oximetry in room air. The patient was diagnosed with anaphylactic shock and was managed with intravenous fluid, adrenaline, dexamethasone sodium phosphate, calcium glucosate, and noradrenaline. Approximately 2 h after treatment, the patient’s anaphylactic shock symptoms had been completely relieved.
CONCLUSION
Due to the widespread use of camrelizumab, attention should be paid to anti-programmed cell death 1 antibody therapy-associated hypersensitivity or anaphylactic shock.
Core Tip: Since its approval in 2019 by the National Drug Administration, camrelizumab (SHR-1210), a programmed cell death 1 inhibitor, is in wide clinical use as a therapeutic option for various tumor types. Until now, allergic reactions induced by camrelizumab have been rarely reported from various studies. For the first time, we report a case of camrelizumab-induced anaphylactic shock in a patient with esophageal squamous cell carcinoma.
