Erre G L, Pardini S, Faedda R, Passiu G
Cattedra e Scuola di Specializzazione di Reumatologia, Italy.
Lupus. 2008 Jan;17(1):50-5. doi: 10.1177/0961203307085251.
Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by a hypercoagulable state related to persistently elevated levels of antiphospholipid antibodies (aPL). Current treatment for APS is only partially effective and new therapies are strongly needed. We report on a case of a 50 years old man with APS who suffered from recurrent thromboembolic episodes despite conventional anticoagulant treatment. Eight years after the first thrombotic manifestation he was diagnosed with a large B cell non-Hodgkin lymphoma. Treatment with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) plus rituximab was started with partial clinical remission of lymphoma and normalization of aPL levels with a three years follow-up period free of thrombotic episodes.A review of the literature revealed that only 12 case reports on the use of rituximab in patients with primary, secondary and catastrophic APS have been published. Current knowledge clearly suggests the need for clinical trials to evaluate the effect of rituximab in the treatment of resistant APS.
抗磷脂综合征（APS）是一种自身免疫性疾病，其特征是与抗磷脂抗体（aPL）持续升高相关的高凝状态。目前对APS的治疗仅部分有效，因此迫切需要新的治疗方法。我们报告了一例50岁的APS男性患者，尽管接受了常规抗凝治疗，但仍反复出现血栓栓塞事件。在首次出现血栓形成表现8年后，他被诊断为大B细胞非霍奇金淋巴瘤。开始使用CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松）加利妥昔单抗进行治疗，淋巴瘤部分临床缓解，aPL水平恢复正常，随访三年无血栓形成事件。文献综述显示，仅发表了12例关于利妥昔单抗用于原发性、继发性和灾难性APS患者的病例报告。目前的知识清楚地表明，需要进行临床试验来评估利妥昔单抗治疗难治性APS的效果。
