Yassa S K, Blessios G, Marinides G, Venuto R C
Department of Medicine, Division of Nephrology, University at Buffalo School of Medicine, Buffalo, NY, USA.
Clin Transplant. 2005 Jun;19(3):423-6. doi: 10.1111/j.1399-0012.2005.00334.x.
Rituximab is a chimaeric monoclonal antibody directed against the CD20 antigen. It has been successfully used in B-cell malignancy and its efficacy in the treatment of in autoimmune hemolytic anemia and other autoimmune diseases is being investigated. There are also few case reports of its success in thrombotic thrombocytopenic purpura, but no reports of its use in hemolytic-uremic syndrome (HUS). We report a 36-year-old patient who had lost the function of her native kidneys secondary to HUS. After more than 1 year in clinical remission, she received a living unrelated kidney transplant. This immediately precipitated a severe relapse of HUS. The process was abrogated but not completely inactivated, despite over 40 plasma exchange treatments. Consequently, she was given Rituximab in courses of two to three doses, each dose 375 mg/m(2), at weekly intervals with remarkable stabilization of her disease for approximately 6 months.
利妥昔单抗是一种针对CD20抗原的嵌合单克隆抗体。它已成功用于治疗B细胞恶性肿瘤，其在自身免疫性溶血性贫血和其他自身免疫性疾病治疗中的疗效正在研究中。也有少数关于其成功治疗血栓性血小板减少性紫癜的病例报告，但尚无其用于溶血尿毒综合征（HUS）的报道。我们报告一名36岁的患者，她因HUS导致自身肾脏功能丧失。在临床缓解超过1年后，她接受了一名非亲属活体肾移植。这立即引发了HUS的严重复发。尽管进行了40多次血浆置换治疗，病情得到了控制但并未完全缓解。因此，她接受了利妥昔单抗治疗，每周间隔给予两到三剂，每剂375mg/m²，病情显著稳定了约6个月。
