Nakamura Akinori, Matsuda Masayuki, Tazawa Ko-Ichi, Shimojima Yasuhiro, Ikeda Shu-Ichi
Department of Rheumatology and Collagen Disease, Shinshu University School of Medicine, Matsumoto.
Intern Med. 2007;46(15):1247-9. doi: 10.2169/internalmedicine.46.0064. Epub 2007 Aug 2.
We report a Japanese patient with familial Mediterranean fever (FMF) who was successfully treated with the anti-tumor necrosis factor (TNF)-alpha monoclonal antibody, infliximab, and low-dose methotrexate. This patient was diagnosed as having FMF based on periodic fever with polyarthralgia typical of this disease and heterozygous mutations in the MEFV gene. Conventional treatment, such as colchicine and reserpine, failed to sufficiently control the FMF attacks. After starting infliximab (3 mg/kg) and low-dose methotrexate (6 mg/week), the frequency of the FMF attacks dramatically decreased and the clinical effect has remained unchanged for longer than 1 year. Combination therapy with infliximab and low-dose methotrexate may be a potent therapeutic option for FMF patients, particularly when conventional treatment is ineffective or cannot be employed because of adverse events.
我们报告了一例患有家族性地中海热（FMF）的日本患者，该患者通过抗肿瘤坏死因子（TNF）-α单克隆抗体英夫利昔单抗和低剂量甲氨蝶呤成功治愈。该患者基于周期性发热伴典型的多关节痛以及MEFV基因杂合突变被诊断为FMF。秋水仙碱和利血平之类的传统治疗方法未能充分控制FMF发作。在开始使用英夫利昔单抗（3mg/kg）和低剂量甲氨蝶呤（6mg/周）后，FMF发作频率显著降低，且临床效果在超过1年的时间里保持不变。英夫利昔单抗和低剂量甲氨蝶呤联合治疗可能是FMF患者的一种有效治疗选择，尤其是当传统治疗无效或因不良事件无法使用时。
