Fuller Louise, Maru Benit, Isserlis Neil, Cerio Rino
Department of Dermatology, Barts Health NHS Trust, London, UK Department of Dermatology, Broomfield Hospital, Essex, UK.
Terumo BCT, Zaventum, Belgium.
BMJ Case Rep. 2015 May 12;2015:bcr2014209008. doi: 10.1136/bcr-2014-209008.
This is a case of a 42-year-old atopic man with severe atopic dermatitis and asthma who despite long-term immunosuppression was not well controlled. He had a very high IgE at 7897 Iu/mL prior to treatment. He underwent two therapeutic plasma exchanges (TPEs) through two peripheral lines in our outpatient department, which led to an absolute decrease of 44.1% and 37% in his plasma IgE for each exchange, and immediate sustained improvement in shortness of breath, and atopic dermatitis, and hence led to a vast improvement in his quality of life. TPE offers a new exciting adjunctive treatment option for severe atopic individuals, where it may provide a novel role to reduce health burden and improve clinical symptoms. Further studies need to be performed to establish an optimal protocol and potential maintenance with recently available targeted anti-IgE biologics.
这是一例42岁的特应性男性患者，患有重度特应性皮炎和哮喘，尽管长期进行免疫抑制治疗，但病情仍未得到良好控制。治疗前他的免疫球蛋白E（IgE）水平非常高，达到7897 Iu/mL。他在我们门诊通过两条外周静脉管路进行了两次治疗性血浆置换（TPE），每次置换后血浆IgE水平绝对下降了44.1%和37%，并使呼吸急促和特应性皮炎症状立即得到持续改善，从而使他的生活质量得到极大提高。TPE为重度特应性个体提供了一种令人兴奋的新辅助治疗选择，它可能在减轻健康负担和改善临床症状方面发挥新作用。需要进一步开展研究以制定最佳方案，并探讨与最近可用的靶向抗IgE生物制剂联合使用的潜在维持治疗方法。
