Suwa A, Hirakata M, Kaneko Y, Sato S, Suzuki Y, Kuwana M
Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Clin Rheumatol. 2009 Feb;28(2):227-9. doi: 10.1007/s10067-008-1050-6. Epub 2008 Dec 9.
We describe a patient who presented with polymyositis with anti-Jo-1 antibodies at 18 years after the onset of rheumatoid arthritis and was successfully treated with the immunosuppressive drug mizoribine at the time of exacerbation. She had developed diabetes mellitus, cerebral infarction, and myocardial infarction after high-dose steroid therapy was initiated. Therefore, an immunosuppressant was preferred as the second-line agent. Treatment with 150 mg/day of mizoribine and 8 mg/day of prednisolone resulted in eventual normalization of muscle enzyme levels. Mizoribine is a purine antimetabolite that inhibits T cell activation/proliferation and B cell proliferation. The potential efficacy of mizoribine for polymyositis was suggested by this case.
我们描述了一名患者，该患者在类风湿关节炎发病18年后出现抗Jo-1抗体阳性的多发性肌炎，并在病情加重时成功接受免疫抑制药物咪唑立宾治疗。在开始大剂量类固醇治疗后，她出现了糖尿病、脑梗死和心肌梗死。因此，首选免疫抑制剂作为二线药物。每天使用150毫克咪唑立宾和8毫克泼尼松龙治疗最终使肌肉酶水平恢复正常。咪唑立宾是一种嘌呤抗代谢物，可抑制T细胞活化/增殖和B细胞增殖。该病例提示了咪唑立宾对多发性肌炎的潜在疗效。
