免疫检查点抑制剂（ICIs）已成为肿瘤学中一类新型抗肿瘤药物。它们融入实践伴随着“免疫相关不良事件”（irAE），其中脱靶免疫反应会损害健康组织。严重的 irAE 可导致不可逆的器官功能障碍和死亡。尽管如此，我们对某些患者易发生 irAE 或促使其发作的因素知之甚少。在此，我们报告一例黑色素瘤患者，该患者完成了辅助免疫治疗，接受了选择性髋关节置换术，并在术后出现了罕见的风湿性 irAE（缓解型血清阴性对称性滑膜炎伴凹陷性水肿）。从机制上讲，我们假设手术作为一种致敏事件导致了 irAE 发病机制，其中在最近的 ICI 给药背景下，自身抗原被呈递给免疫系统，而外周耐受性降低。该病例强调了未来进行相关分析的必要性，调查手术等医源性干预措施是否可能与 irAE 的发生有关。© 2023 作者。由巴塞尔 S. Karger AG 出版。

Immune checkpoint inhibitors (ICIs) have emerged as a novel class of anti-neoplastic agent in oncology. Their integration into practice has been accompanied by "immune-related adverse events" (irAEs) wherein off-target immune responses damage healthy tissues. Severe irAEs can cause irreversible organ dysfunction and death. Despite this, little is known about factors which predispose certain patients to develop irAEs or which precipitate their onset. Here, we report a case of a patient with melanoma who completed adjuvant immunotherapy, underwent elective hip replacement, and developed a rare rheumatologic irAE (remitting seronegative symmetrical synovitis with pitting edema) post-operatively. Mechanistically, we hypothesize that surgery contributed to irAE pathogenesis as a sensitizing event in which self-antigens were presented to an immune system with diminished peripheral tolerance in the context of recent ICI administration. This case highlights a need for future correlative analyses, investigating whether iatrogenic interventions such as surgery might be associated with irAE development.© 2023 The Author(s). Published by S. Karger AG, Basel.