Tajiri Kazuto, Tsuneyama Koichi, Miyazono Takahiro, Kawai Kengo, Minemura Masami, Sugiyama Toshiro
The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Case Rep Gastroenterol. 2013 Apr 19;7(1):195-201. doi: 10.1159/000351173. Print 2013 Jan.
Primary biliary cirrhosis (PBC) is a progressive liver disease for which limited therapies are recommended. Rituximab, an anti-CD20 monoclonal antibody, is expected to be a useful therapeutic regimen for PBC. Previous studies indicated biochemical and immunological improvement in PBC after rituximab treatment. Although rituximab shows therapeutic potential for PBC, few cases have been reported and histological improvement and long-term outcome remain uncertain. Here, we report a case of PBC in a 66-year-old Japanese female patient who presented with a gastric lymphoma and who had been treated with a regimen containing rituximab for incidental malignant lymphoma. She showed biochemical and immunological improvements, and liver histology before and after rituximab treatment confirmed a decrease in liver inflammation. However, she developed liver cirrhosis a short time after rituximab treatment without biochemical or immunological worsening. Rituximab treatment for PBC might be considered and careful observation is required after treatment.
原发性胆汁性肝硬化（PBC）是一种进展性肝病，目前推荐的治疗方法有限。利妥昔单抗是一种抗CD20单克隆抗体，有望成为治疗PBC的有效方案。既往研究表明，利妥昔单抗治疗后PBC患者的生化指标和免疫功能有所改善。尽管利妥昔单抗对PBC显示出治疗潜力，但报道的病例较少，其组织学改善情况和长期疗效仍不确定。在此，我们报告一例66岁日本女性PBC患者，该患者同时患有胃淋巴瘤，并因偶然发现的恶性淋巴瘤接受了含利妥昔单抗的治疗方案。她的生化指标和免疫功能得到改善，利妥昔单抗治疗前后的肝脏组织学检查证实肝脏炎症减轻。然而，她在利妥昔单抗治疗后不久出现肝硬化，且生化指标和免疫功能并未恶化。对于PBC患者可考虑使用利妥昔单抗治疗，但治疗后需要密切观察。
