摘要1例56岁男性患者肾癌复发并脾脏转移，口服舒尼替尼（50 mg/d，用药4周、停药2周为1个周期，2个周期后减量至25 mg/d），因病情需要，加用帕博利珠单抗（100 mg静脉滴注，1次/3周）。应用舒尼替尼3个周期、帕博利珠单抗5个周期后，患者出现肌肉和关节疼痛、关节肿胀、活动障碍、肢端感觉异常，并陆续出现排便困难、饮水呛咳、吞咽和呼吸困难等症状。经神经内科医师会诊后被诊断为吉兰-巴雷综合征，考虑可能与联合应用舒尼替尼和帕博利珠单抗有关。停用上述两种药物，给予地塞米松、静脉注射用人免疫球蛋白（pH4），3 d后患者可自行翻身；5 d后吞咽、呼吸困难和肌肉、关节疼痛症状缓解；10 d后可在床旁站立；1个半月后可以独立行走。

abstractsA 56-year-old male patient with recurrent renal cell carcinoma and splenic metastasis received oral sunitinib 50 mg/d (4 weeks of medication and 2 weeks of withdrawal were defined as 1 cycle; the dosage was reduced to 25 mg/d after 2 cycles). And intravenous infusion of pembrolizumab 100 mg once every 3 weeks was added because of his illness. After 3 cycles of sunitinib and 5 cycles of pembrolizumab treatments, the patient developed muscle and joint pain, joint swelling, movement disorder, abnormal limb sensation and gradually developed symptoms such as difficulty in defecation, choking of drinking water, dysphagia, and dyspnea. The patient was diagnosed as Guillain-Barre syndrome after neurologist consultation, which might be related to the combination use of sunitinib and pembrolizumab. The above 2 drugs were stopped and dexamethasone and human immunoglobulin (pH4) for intravenous injection were given. Three days later, the patient could turn over on his own; 5 days later, his symptoms of dysphagia, dyspnea, and muscle and joint pain were relieved; 10 days later, he could stand beside the bed; one and a half month later, he could walk independently.