El-Reshaid Kamel, Madda John Patrick
Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Case Rep Dermatol. 2013 Apr 16;5(1):115-9. doi: 10.1159/000350559. Print 2013 Jan.
We report our clinical experience with rituximab in the treatment of 2 patients with idiopathic cutaneous angiitis who relapsed after treatment with high-dose corticosteroids and cyclophosphamide. A 39-year-old woman and a 51-year-old man presented with ulcerating maculopapular rash in both lower limbs which relapsed 6 months after treatment with a combination of high-dose corticosteroids and cyclophosphamide. After treatment with 2 g of rituximab, the first patient has still been in clinical remission for 32 months while the second has finished 28 months. Interestingly, CD19 which had dropped to <0.1 one week following the start of retuximab had increased to >0.5% 8 months later in both patients. Despite that, our patients are still in clinical remission. No significant side effects were noted during infusions and up to the period of follow-up. In conclusion, rituximab is a useful and safe agent in the treatment of idiopathic cutaneous angiitis refractory to conventional therapy. Clinical remission persists years after improvement of B-cell suppression.
我们报告了利妥昔单抗治疗2例特发性皮肤血管炎患者的临床经验，这2例患者在接受大剂量皮质类固醇和环磷酰胺治疗后复发。一名39岁女性和一名51岁男性均表现为双下肢溃疡性斑丘疹皮疹，在接受大剂量皮质类固醇和环磷酰胺联合治疗6个月后复发。在接受2g利妥昔单抗治疗后，首例患者已临床缓解32个月，而第二例已缓解28个月。有趣的是，两名患者在开始使用利妥昔单抗一周后降至<0.1%的CD19，在8个月后均升至>0.5%。尽管如此，我们的患者仍处于临床缓解状态。输注期间及随访期间均未发现明显副作用。总之，利妥昔单抗是治疗对传统疗法难治的特发性皮肤血管炎的一种有效且安全的药物。在B细胞抑制改善多年后仍持续临床缓解。
