Sharif K, Watad A, Bragazzi N L, Asher E, Abu Much A, Horowitz Y, Lidar M, Shoenfeld Y, Amital H
Department of Medicine "B", Sheba Medical Center, Tel-Hashomer, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Hashomer, Israel.
J Clin Pharm Ther. 2017 Jun;42(3):356-362. doi: 10.1111/jcpt.12522.
Rituximab is a chimeric monoclonal anti-CD20 antibody approved for the treatment of some lymphoid malignancies as well as for autoimmune diseases including rheumatoid arthritis (RA), idiopathic thrombocytopenic purpura (ITP) and vasculitis. Generally, rituximab is well tolerated; nevertheless, some patients develop adverse effects including infusion reactions. Albeit rare, these reactions may in some cases be life-threatening conditions. Rituximab cardiovascular side effects include more common effects such as hypertension, oedema and rare cases of arrhythmias and myocardial infarction.
In this article, we report a case of a 58-year-old man with a history of overlap syndrome including RA and limited scleroderma who was treated with rituximab and developed a dramatic ST-elevation myocardial infarction (STEMI) during the drug administration.
This report underlines previous published reports emphasizing the awareness of such an association. This communication also warrants the importance of screening for ischaemic heart disease in selected cases of patients treated with rituximab.
利妥昔单抗是一种嵌合单克隆抗CD20抗体，被批准用于治疗某些淋巴系统恶性肿瘤以及自身免疫性疾病，包括类风湿关节炎（RA）、特发性血小板减少性紫癜（ITP）和血管炎。一般来说，利妥昔单抗耐受性良好；然而，一些患者会出现不良反应，包括输液反应。尽管这些反应罕见，但在某些情况下可能会危及生命。利妥昔单抗的心血管副作用包括更常见的影响，如高血压、水肿以及罕见的心律失常和心肌梗死病例。
在本文中，我们报告了一例58岁男性患者，有重叠综合征病史，包括RA和局限性硬皮病，接受利妥昔单抗治疗，并在用药期间发生了严重的ST段抬高型心肌梗死（STEMI）。
本报告强调了之前发表的报告，即强调对此类关联的认识。本交流也证明了在接受利妥昔单抗治疗的特定患者病例中筛查缺血性心脏病的重要性。
