Zhou Ying, Lower Elyse E, Li Huiping, Baughman Robert P
Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH, 45267, USA; Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China.
Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH, 45267, USA.
Respir Med Case Rep. 2015 Nov 19;17:5-7. doi: 10.1016/j.rmcr.2015.11.001. eCollection 2016.
Infliximab is an effective treatment for sarcoidosis patients with persistent disease despite glucocorticoids and immunosuppressive therapy. Patients receiving infliximab can experience side effects, inducing an autoimmune reaction. Treatment is unclear for sarcoidosis patients who develop autoimmune reactions to infliximab. We report a case of a patient with advanced sarcoidosis who developed a myositis type reaction to infliximab characterized by diffuse muscle achiness and weakness and marked elevations in serum creatinine phosphokinase (CPK) and aldolase. Manifestations of sarcoidosis and myositis improved after Acthar treatment. This is the first report of successful treatment with Acthar in a patient with advanced sarcoidosis with an autoimmune reaction to infliximab.
英夫利昔单抗对于尽管接受了糖皮质激素和免疫抑制治疗但仍患有持续性疾病的结节病患者是一种有效的治疗方法。接受英夫利昔单抗治疗的患者可能会出现副作用，引发自身免疫反应。对于对英夫利昔单抗产生自身免疫反应的结节病患者，治疗方法尚不清楚。我们报告了一例晚期结节病患者，该患者对英夫利昔单抗产生了肌炎样反应，其特征为弥漫性肌肉疼痛和无力，以及血清肌酸磷酸激酶（CPK）和醛缩酶显著升高。促肾上腺皮质激素（Acthar）治疗后，结节病和肌炎的表现有所改善。这是首例使用促肾上腺皮质激素成功治疗对英夫利昔单抗产生自身免疫反应的晚期结节病患者的报告。
