霉酚酸酯成功治疗狼疮性脑血管病

Successful Treatment of Lupus Cerebrovascular Disease with Mycophenolate Mofetil.

作者信息

Higashioka Kazuhiko, Yoshida Kenji, Oryoji Kensuke, Kamada Kazuo, Mizuki Shinichi, Tsukamoto Hiroshi, Yokota Eisuke, Akashi Koichi

机构信息

Division of Rheumatology, Matsuyama Red Cross Hospital, Japan.

出版信息

Intern Med. 2015;54(17):2255-9. doi: 10.2169/internalmedicine.54.4582. Epub 2015 Sep 1.

DOI:10.2169/internalmedicine.54.4582

PMID:26328657

Abstract

We report a case of neuropsychiatric systemic lupus erythematosus successfully treated with mycophenolate mofetil (MMF). The patient was a 40-year-old female who maintained with 7 mg of prednisolone plus 100 mg of azathioprine (AZ) per day. According to transient ischemic attack that occurred repeatedly and an elevated level of interleukin-6 (IL-6) in spinal fluid, she was diagnosed as having neuropsychiatric systemic lupus erythematosus (NPSLE). Initial increase in doses of prednisolone and AZ to 20 mg and 150 mg per day, respectively, was ineffective. After switching from AZ to MMF, her symptoms of NPSLE completely resolved with marked improvement of the IL-6 level in her spinal fluid, suggesting that MMF was effective.

摘要

我们报告了一例用霉酚酸酯（MMF）成功治疗的神经精神性系统性红斑狼疮病例。该患者为一名40岁女性，每天服用7毫克泼尼松龙加100毫克硫唑嘌呤（AZ）维持治疗。根据反复发生的短暂性脑缺血发作以及脑脊液中白细胞介素-6（IL-6）水平升高，她被诊断为患有神经精神性系统性红斑狼疮（NPSLE）。最初将泼尼松龙和AZ的剂量分别增加至每天20毫克和150毫克无效。从AZ换用MMF后，她的NPSLE症状完全缓解，脑脊液中IL-6水平明显改善，提示MMF有效。