Tarrant Teresa K, Frazer D Hugh, Aya-Ay James P, Patel Dhavalkumar D
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
J Rheumatol. 2003 Feb;30(2):412-4.
Systemic lupus erythematosus (SLE) pathogenesis is mediated in part by autoantibodies. We describe a patient with central nervous system lupus who developed a loss of B cells with associated hypogammaglobulinemia and sinopulmonary infections requiring intravenous immunoglobulin. The SLE went into complete remission. Of 18 reported patients with SLE developing persistent hypogammaglobulinemia, only 5 patients including ours had a nearly complete loss of circulating B cells. Of those whose SLE and B cell status was reported, 5/5 with B cell loss and 1/10 without B cell loss experienced a durable response of SLE (p = 0.002). These cases illustrate that B cell ablative therapies may have efficacy for SLE.
系统性红斑狼疮（SLE）的发病机制部分由自身抗体介导。我们描述了一名患有中枢神经系统狼疮的患者，该患者出现B细胞缺失，并伴有低丙种球蛋白血症和需要静脉注射免疫球蛋白的鼻窦肺部感染。该SLE进入完全缓解期。在18例报告的发生持续性低丙种球蛋白血症的SLE患者中，只有包括我们的患者在内的5例患者循环B细胞几乎完全缺失。在报告了SLE和B细胞状态的患者中，5例B细胞缺失的患者中有5例、10例无B细胞缺失的患者中有1例SLE获得持久缓解（p = 0.002）。这些病例表明，B细胞清除疗法可能对SLE有效。
