Sadreddini Shahram, Noshad Hamid, Molaeefard Mahshid, Noshad Rahim
Tabriz University of Medical Sciences, Golgasht St., Tabriz, Iran.
Mod Rheumatol. 2008;18(3):306-8. doi: 10.1007/s10165-008-0057-9. Epub 2008 Apr 26.
Behçet's disease (BD) is more common in eastern than western countries. Physicians have frequently encountered problems in its treatment, especially eye involvement. Recurrent oral and genital aphthous ulcerations are the hallmarks of Behçet's disease but other organs can be involved and ocular disease is one of the most disabling manifestations. Up to now, there are some problems in treatment of the retinal vasculitis due to Behçet's disease. We reported one patient, with visual loss due to retinal vasculitis that was resistant to prednisolone and azathioprine. Our patient was treated successfully with rituximab and his remission was sustained for 24 months of follow-up. Rituximab is a chimeric monoclonal antibody that acts against the specific B cell antigen, CD20. The recent success of rituximab in autoimmune diseases, which is considered to be T cell-mediated, indicates that B cells must have a much broader role in the pathogenesis of autoimmune diseases than generally appreciated.
白塞病(BD)在东方国家比西方国家更为常见。医生在其治疗中经常遇到问题,尤其是眼部受累情况。复发性口腔和生殖器阿弗他溃疡是白塞病的标志,但其他器官也可能受累,眼部疾病是最具致残性的表现之一。到目前为止,白塞病所致视网膜血管炎的治疗存在一些问题。我们报告了1例因视网膜血管炎导致视力丧失且对泼尼松龙和硫唑嘌呤耐药的患者。我们的患者接受利妥昔单抗治疗成功,在24个月的随访中病情持续缓解。利妥昔单抗是一种针对特定B细胞抗原CD20的嵌合单克隆抗体。利妥昔单抗在被认为是T细胞介导的自身免疫性疾病中的近期成功表明,B细胞在自身免疫性疾病发病机制中的作用必定比普遍认为的更为广泛。