利妥昔单抗治疗自身免疫性溶血性贫血。

Rituximab for treatment of autoimmune hemolytic anemia.

机构信息

Department of Pediatrics, Mother and Child Health Institute Dr Vukan Cupic, University of Belgrade, Faculty of Medicine and University of Kragujevac, Faculty of Medicine, Serbia.

出版信息

Indian Pediatr. 2012 Aug;49(8):672-4.

PMID:22962244

Abstract

We report the successful use of rituximab as single treatment modality in a five-month-old boy with fulminant warm autoantibody autoimmune hemolytic anemia, resistant to standard treatment. On admission, laboratory tests showed a profound anemia with a hemoglobin of 2.6 g/dL. Indirect and direct antiglobulin tests were strongly positive, and nonspecific IgG autoantibodies were detected. Two days of intravenous corticosteroids (methylprednisolone 4mg/kg) and immunoglobulins (1g/kg) did not halt the hemolysis and the infant was severely transfusion-dependent. Rituximab 375mg/sq m weekly was given for 4 weeks, the hepatosplenomegaly gradually regressed, the lymphocytes normalized and he is free from hemolysis two years after treatment.

摘要

我们报告了一例 5 月龄男婴暴发性温自身抗体自身免疫性溶血性贫血，对标准治疗耐药，成功使用利妥昔单抗作为单一治疗方法。入院时，实验室检查显示严重贫血，血红蛋白为 2.6g/dL。间接和直接抗球蛋白试验均呈强阳性，检测到非特异性 IgG 自身抗体。静脉注射皮质类固醇（甲泼尼龙 4mg/kg）和免疫球蛋白（1g/kg）治疗 2 天未能阻止溶血，婴儿严重依赖输血。给予利妥昔单抗 375mg/㎡，每周一次，共 4 周，肝脾肿大逐渐消退，淋巴细胞恢复正常，治疗 2 年后无溶血。