Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Int Immunopharmacol. 2010 May;10(5):632-4. doi: 10.1016/j.intimp.2010.02.007. Epub 2010 Feb 19.
Autoimmune thrombocytopenic purpura (ATP) in systemic lupus erythematosus involves autoantibody mediated destruction of platelets. In dialysis patients with refractory ATP which is unresponsive to corticosteroid and immunosuppressive agents, the management is difficult. B cell targeted therapy with rituximab has emerged as a promising agent by reducing the levels of pathogenic autoantibodies. However, its safety and efficacy in dialysis patients are uncertain. In this report, we described a dialysis patient with refractory lupus-related ATP, whose platelet counts responded only to rituximab. Furthermore, no severe side effects were noted during the treatment period, suggesting that rituximab can be administered safely in dialysis patients.
自身免疫性血小板减少性紫癜（ATP）在系统性红斑狼疮中涉及自身抗体介导的血小板破坏。对于类固醇和免疫抑制剂治疗反应不佳的透析患者难治性 ATP，其管理较为困难。利妥昔单抗等 B 细胞靶向治疗通过降低致病性自身抗体水平，已成为一种有前途的治疗药物。然而，其在透析患者中的安全性和疗效尚不确定。在本报告中，我们描述了 1 例透析患者的难治性狼疮相关 ATP，其血小板计数仅对利妥昔单抗有反应。此外，在治疗期间未出现严重的副作用，提示利妥昔单抗可安全地用于透析患者。
