一名服用芬戈莫德治疗多发性硬化症的患者发生皮肤隐球菌病：机会性感染会接踵而至吗？
Cutaneous cryptococcosis in a patient taking fingolimod for multiple sclerosis: Here come the opportunistic infections?
作者信息
Carpenter Adam F, Goodwin Shikha J, Bornstein Peter F, Larson Andrew J, Markus Christine K
机构信息
Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA/Brain Sciences Center, VA Medical Center, Minneapolis, MN, USA.
St. Paul Infectious Disease Associates, Ltd., St. Paul, MN, USA/Allina Health, St. Paul, MN, USA.
出版信息
Mult Scler. 2017 Feb;23(2):297-299. doi: 10.1177/1352458516670732.
BACKGROUND
Fingolimod is an oral disease-modifying therapy for relapsing forms of multiple sclerosis, which acts by sequestering lymphocytes within lymph nodes.
OBJECTIVE
To describe a case of extrapulmonary cryptococcosis in a patient taking fingolimod.
METHODS
Case report.
RESULTS
A 47-year-old man developed a non-healing skin lesion approximately 16 months after starting treatment with fingolimod. Biopsy revealed cryptococcosis. Fingolimod was discontinued and the lesion resolved with antifungal therapy.
CONCLUSION
Despite few reported opportunistic infections in the pivotal clinical trials and first few years post-marketing, there has been a recent increase in reported AIDS-defining illnesses in patients taking fingolimod. Neurologists should be alert for opportunistic infections in their patients using this medication.
背景
芬戈莫德是一种用于复发型多发性硬化症的口服疾病修正疗法，其作用机制是将淋巴细胞隔离在淋巴结内。
目的
描述1例服用芬戈莫德的患者发生肺外隐球菌病的病例。
方法
病例报告。
结果
一名47岁男性在开始使用芬戈莫德治疗约16个月后出现了一个不愈合的皮肤病变。活检显示为隐球菌病。停用芬戈莫德，病变经抗真菌治疗后消退。
结论
尽管在关键临床试验及上市后的头几年中报告的机会性感染较少，但最近服用芬戈莫德的患者中报告的艾滋病定义疾病有所增加。神经科医生应对使用这种药物的患者的机会性感染保持警惕。
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