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[类风湿关节炎与自身免疫性溶血:B细胞清除疗法诱导一名类风湿关节炎合并冷凝集素病患者缓解]

[Rheumatoid arthritis and autoimmune hemolysis: B-cell depletion for remission induction in a patient with rheumatoid arthritis and cold agglutinin disease].

作者信息

Lehmann P, Hartung W, Ehrenstein B, Schölmerich J, Fleck M

机构信息

Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, 93042 Regensburg.

出版信息

Z Rheumatol. 2010 Aug;69(6):557-60. doi: 10.1007/s00393-010-0607-3.

Abstract

Autoimmune hemolysis is a rare complication of systemic rheumatic diseases. We report on a 68-year-old female patient with established, long-standing rheumatoid arthritis, who complained of progressive weakness and worsening of her arthralgia under therapy with leflunomide. Physical and laboratory examination revealed autoimmune hemolysis due to cold agglutinin disease. As hemolysis and arthritis were refractory to steroid treatment, B-cell depletion with rituximab was performed leading to a marked reduction of hemolytic parameters as well as remission of her rheumatoid arthritis.

摘要

自身免疫性溶血是系统性风湿性疾病的一种罕见并发症。我们报告了一名68岁患有确诊且病程较长的类风湿关节炎的女性患者,她在接受来氟米特治疗期间主诉进行性虚弱和关节痛加重。体格检查和实验室检查显示为冷凝集素病所致的自身免疫性溶血。由于溶血和关节炎对类固醇治疗无效,遂使用利妥昔单抗进行B细胞清除,结果导致溶血参数显著降低以及类风湿关节炎缓解。

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