一名接受聚乙二醇干扰素加利巴韦林治疗的慢性丙型肝炎病毒感染患者获得性甲型血友病：利妥昔单抗的作用
Acquired haemophilia A in a patient with chronic hepatitis C virus infection receiving treatment with pegylated interferon plus ribarivin: role of rituximab.
作者信息
Fernández de Palencia Espinosa M Á, Arocas Casañ V, Garrido Corro B, de la Rubia Nieto A
机构信息
Servicio de Farmacia. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia. España.
出版信息
Farm Hosp. 2013 Nov-Dec;37(6):494-8. doi: 10.7399/FH.2013.37.6.686.
BACKGROUND
Acquired haemophilia is an uncommon condition caused by the development of clotting factor inhibitors. To eliminate them, immunosuppressive therapy with corticosteroids and cytotoxic drugs is required.
METHODS
We describe a case of rituximab use in acquired haemophilia refractory to conventional therapy in a 63 year old male patient with chronic hepatitis C virus infection who was receiving treatment with pegylated-interferon-a-2a plus ribavirin.
RESULTS
After 21 weeks of antiviral therapy, the patient was admitted to hospital with a large haematoma in the abdominal muscles. Factor VIII level was zero and inhibitor titer was 345 Bethesda units. Oral immunosuppressive therapy with methylprednisolone and cyclophosphamide was administered for 1 month, with limited improvement. Therefore, cyclophosphamide was replaced by a four once-weekly dose of intravenous rituximab. Two months later, factor VIII level was normal and inhibitor titer was undetectable.
CONCLUSION
Rituximab may be useful for the treatment of acquired haemophilia resistant to standard therapy.
背景
获得性血友病是一种由凝血因子抑制剂产生所导致的罕见病症。为消除这些抑制剂，需要使用皮质类固醇和细胞毒性药物进行免疫抑制治疗。
方法
我们描述了一例在一名63岁慢性丙型肝炎病毒感染男性患者中使用利妥昔单抗治疗获得性血友病的病例，该患者正在接受聚乙二醇化干扰素α-2a加利巴韦林治疗。
结果
抗病毒治疗21周后，患者因腹部肌肉出现巨大血肿入院。凝血因子VIII水平为零，抑制剂滴度为345贝塞斯达单位。给予甲基泼尼松龙和环磷酰胺口服免疫抑制治疗1个月，改善有限。因此，将环磷酰胺替换为每周一次静脉注射利妥昔单抗共四次的方案。两个月后，凝血因子VIII水平正常，且未检测到抑制剂滴度。
结论
利妥昔单抗可能对治疗标准疗法耐药的获得性血友病有用。
Zotero 插件