Tagawa Y, Saito T, Takada K, Kawahata K, Kohsaka H
Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
Lupus. 2016 Apr;25(5):543-6. doi: 10.1177/0961203315625118. Epub 2016 Jan 12.
Systemic lupus erythematosus-related hepatitis, known as lupus hepatitis, is a rare manifestation of systemic lupus erythematosus, and is usually subclinical with mild abnormalities of serum liver enzymes. While cases with clinically significant and refractory lupus hepatitis are uncommon, treatment options for lupus hepatitis are to be established. Here, we report the case of a 45-year-old man with progressive lupus hepatitis accompanied by autoimmune haemolytic anaemia. Lupus hepatitis of this patient was refractory to tacrolimus, azathioprine and cyclophosphamide, but was successfully treated by mycophenolate mofetil. Mycophenolate mofetil might be an effective therapeutic option for refractory lupus hepatitis.
系统性红斑狼疮相关肝炎,即狼疮性肝炎,是系统性红斑狼疮的一种罕见表现,通常为亚临床状态,血清肝酶仅有轻度异常。虽然具有临床显著意义且难治的狼疮性肝炎病例并不常见,但狼疮性肝炎的治疗方案仍有待确立。在此,我们报告一例45岁男性进行性狼疮性肝炎伴自身免疫性溶血性贫血的病例。该患者的狼疮性肝炎对他克莫司、硫唑嘌呤和环磷酰胺治疗无效,但霉酚酸酯治疗成功。霉酚酸酯可能是难治性狼疮性肝炎的一种有效治疗选择。