A 36-year-old female patient with no significant medical history except hypothyroidism was diagnosed with left parotid acinic cell carcinoma that was treated by radical parotidectomy followed by adjuvant radiotherapy (50 Gy) in 2004. Seven years after the initial diagnosis, the patient developed histologically confirmed metastases on the left adrenal gland and the lung, for which systemic therapy was indicated. The patient participated in two successive studies and received lapatinib and then an EZH-2 inhibitor. In March 2016, the patient’s adrenal lesion progressed, and she started treatment with pembrolizumab, 200 mg, every 3 weeks. At the time of the 11th injection, the patient experienced a retinal detachment that was linked to her myopia. The detachment was treated by surgery and amoxicillin for 7 days. Subsequently, the patient developed an oral candidiasis that was treated with systemic fungizone. At the time of the 13th injection, in December 2016, the patient experienced a debilitating grade 2 dry-eye syndrome that was associated with grade 1 conjunctival hyperemia, grade 2 xerostomia, and grade 1 skin rash on both hands. Therefore, serum protein electrophoresis (SPEP) and determination of antinuclear antibodies (ANA) [particularly Sjogren’s syndrome A/Sjogren’s syndrome B (SSA/SSB)] were carried out. A salivary gland biopsy could not be conducted because of the patient’s radiation history. The SPEP and the ANA were normal. Concomitantly, the CT-scan showed a stable disease using the RECIST criteria v1.1.

中文翻译：

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PD-1抑制剂治疗下的Gougerot-Sjogren样综合征。

一名36岁的女性患者，除甲状腺功能减退外无明显病史，被诊断为左腮腺腺癌细胞，于2004年接受根治性腮腺切除术并辅以放疗（50 Gy）进行治疗。初诊七年后，患者发展为经组织学确认的左肾上腺和肺转移，建议进行全身治疗。该患者参加了两次连续研究，接受拉帕替尼治疗，然后接受EZH-2抑制剂治疗。2016年3月，患者的肾上腺病变进展，她开始每3周服用200 mg派姆单抗治疗。在第11次注射时，患者经历了与近视有关的视网膜脱离。通过手术和阿莫西林治疗该脱离7天。随后，患者发展为口服念珠菌病，接受全身性真菌素治疗。在2016年12月进行第13次注射时，患者经历了使人衰弱的2级干眼综合征，其伴有1级结膜充血，2级口腔干燥症和双手1级皮疹。因此，进行了血清蛋白电泳（SPEP）和抗核抗体（ANA）[特别是干燥综合征A /干燥综合征B（SSA / SSB）]的测定。由于患者的放射史，无法进行唾液腺活检。SPEP和ANA正常。同时，使用RECIST标准v1.1，CT扫描显示疾病稳定。患者经历了令人衰弱的2级干眼症候群，并伴有1级结膜充血，2级口腔干燥症和双手1级皮疹。因此，进行了血清蛋白电泳（SPEP）和抗核抗体（ANA）[特别是干燥综合征A /干燥综合征B（SSA / SSB）]的测定。由于患者的放射史，无法进行唾液腺活检。SPEP和ANA正常。同时，使用RECIST标准v1.1，CT扫描显示疾病稳定。患者经历了令人衰弱的2级干眼症候群，并伴有1级结膜充血，2级口腔干燥症和双手1级皮疹。因此，进行了血清蛋白电泳（SPEP）和抗核抗体（ANA）[特别是干燥综合征A /干燥综合征B（SSA / SSB）]的测定。由于患者的放射史，无法进行唾液腺活检。SPEP和ANA正常。同时，使用RECIST标准v1.1，CT扫描显示疾病稳定。进行血清蛋白电泳（SPEP）和抗核抗体（ANA）[特别是干燥综合征A /干燥综合征B（SSA / SSB）]的测定。由于患者的放射史，无法进行唾液腺活检。SPEP和ANA正常。同时，使用RECIST标准v1.1，CT扫描显示疾病稳定。进行血清蛋白电泳（SPEP）和抗核抗体（ANA）[特别是干燥综合征A /干燥综合征B（SSA / SSB）]的测定。由于患者的放射史，无法进行唾液腺活检。SPEP和ANA正常。同时，使用RECIST标准v1.1，CT扫描显示疾病稳定。