利妥昔单抗治疗免疫球蛋白G4相关性胆管炎所致难治性胆管狭窄
Rituximab therapy for refractory biliary strictures in immunoglobulin G4-associated cholangitis.
作者信息
Topazian Mark, Witzig Thomas E, Smyrk Thomas C, Pulido Jose S, Levy Michael J, Kamath Patrick S, Chari Suresh T
机构信息
Miles and Shirley Fiterman Center for Digestive Diseases, Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55906, USA.
出版信息
Clin Gastroenterol Hepatol. 2008 Mar;6(3):364-6. doi: 10.1016/j.cgh.2007.12.020.
BACKGROUND & AIMS: Biliary strictures occur in a third of patients with autoimmune pancreatitis and have been termed immunoglobulin G subclass 4 (IgG4) associated cholangitis (IAC). IAC often responds to steroid therapy.
METHODS
A patient with autoimmune pancreatitis and (IAC) refractory to steroids and 6-mercaptopurine was treated with rituximab, a monoclonal antibody directed against the CD20 antigen on B lymphocytes.
RESULTS
The patient's biliary strictures improved after rituximab therapy, permitting removal of his biliary stents. Systemic manifestations of IgG4-associated disease also improved.
CONCLUSIONS
Rituximab may be a treatment option for patients with refractory or recurrent autoimmune pancreatitis or IAC.
背景与目的
三分之一的自身免疫性胰腺炎患者会出现胆管狭窄，这种情况被称为免疫球蛋白G4（IgG4）相关性胆管炎（IAC）。IAC通常对类固醇治疗有反应。
方法
一名自身免疫性胰腺炎合并IAC且对类固醇和6-巯基嘌呤治疗无效的患者接受了利妥昔单抗治疗，利妥昔单抗是一种针对B淋巴细胞上CD20抗原的单克隆抗体。
结果
利妥昔单抗治疗后，患者的胆管狭窄情况有所改善，从而可以移除胆管支架。IgG4相关性疾病的全身表现也有所改善。
结论
利妥昔单抗可能是难治性或复发性自身免疫性胰腺炎或IAC患者的一种治疗选择。
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