细胞因子释放综合征（CRS）是一种急性全身炎症综合征，以发热和多器官衰竭为特征，由免疫治疗或某些感染引发。免疫检查点抑制剂很少引起免疫相关不良事件——细胞因子释放综合征（irAE-CRS）。本文介绍了 2019 年冠状病毒病 (COVID-19) 引发的 irAE-CRS 病例报告。一名 60 岁的 2 型糖尿病男性接受纳武单抗治疗食管胃交界癌，并经历了两种免疫相关不良事件：甲状腺功能减退症和皮肤病。在他来我们医院就诊前 11 天，他发烧并被诊断出患有 COVID-19。就诊前五天，他再次发烧，并伴有全身不适、水溶性腹泻和四肢肌痛。入院时，患者已处于多器官功能衰竭状态，虽然感染源不明，但初步诊断为感染性休克。尽管使用抗菌药物、大剂量血管升压药和静脉输液进行全身治疗，但患者的病情仍不稳定。根据他的纳武单抗使用史，我们怀疑因 irAE (irAE-CRS) 导致 CRS。开始类固醇冲击治疗（甲泼尼龙 1 g/天），患者暂时康复。然而，他的呼吸系统状况却恶化了；因此，他使用了呼吸机，并在治疗中添加了托珠单抗。他的肌肉力量恢复到可以在家生活的程度，随后出院。对于既往接受免疫检查点抑制剂治疗的患者，当除了炎症表现外还观察到多器官损伤时，应考虑将irAE-CRS作为鉴别诊断。建议开始使用类固醇治疗；如果疾病难治，应尽早引入托珠单抗等其他免疫抑制疗法。© 2024。作者。

Cytokine release syndrome (CRS) is an acute systemic inflammatory syndrome characterized by fever and multiple organ failure, which is triggered by immunotherapy or certain infections. Immune checkpoint inhibitors rarely cause immune-related adverse event- cytokine release syndrome (irAE-CRS). This article presents a case report of irAE-CRS triggered by coronavirus disease 2019 (COVID-19).A 60-year-old man with type 2 diabetes received nivolumab treatment for esophagogastric junction carcinoma and experienced two immune-related adverse events: hypothyroidism and skin disorder. Eleven days before his visit to our hospital, he had a fever and was diagnosed with COVID-19. Five days before his visit, he developed a fever again, along with general malaise, water soluble diarrhea, and myalgia of the extremities. On admission, the patient was in a state of multiple organ failure, and although the source of infection was unknown, a tentative diagnosis of septic shock was made. The patient's condition was unstable despite systemic management with antimicrobial agents, high-dose vasopressors, and intravenous fluids. We suspected CRS due to irAE (irAE-CRS) based on his history of nivolumab use. Steroid pulse therapy (methylprednisolone 1 g/day) was started, and the patient temporarily recovered. However, his respiratory condition worsened; consequently, he was placed on a ventilator and tocilizumab was added to the treatment. His muscle strength recovered to the point where he could live at home, and was subsequently discharged.In patients previously treated with immune checkpoint inhibitors, irAE-CRS should be considered as a differential diagnosis when multiple organ damage is observed in addition to inflammatory findings. It is recommended to start treatment with steroids; if the disease is refractory, other immunosuppressive therapies such as tocilizumab should be introduced as early as possible.© 2024. The Author(s).