Azuma Naoto, Matsui Kiyoshi, Hashimoto Naoaki, Yoshikawa Takahiro, Sano Hajime
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Japan.
Hashimoto Clinic for Rheumatic Diseases, Japan.
Intern Med. 2017;56(12):1585-1590. doi: 10.2169/internalmedicine.56.8168. Epub 2017 Jun 15.
Biologics used in the treatment of rheumatoid arthritis (RA) rarely cause eosinophilia. We herein report a patient with RA being treated with infliximab, adalimumab, and tocilizumab who developed eosinophilia with skin symptoms. Interestingly, the marked eosinophilia and skin symptoms did not reappear after the patient's medication was switched to golimumab. In this case, the presence of biologics-specific antibodies suggested that immunogenicity caused the eosinophilia. Therefore, switching to a biologic with a lower immunogenicity was effective. These findings may be helpful for clinicians treating patients with biologics-induced eosinophilia.
用于治疗类风湿性关节炎(RA)的生物制剂很少引起嗜酸性粒细胞增多。我们在此报告一名接受英夫利昔单抗、阿达木单抗和托珠单抗治疗的RA患者出现了伴有皮肤症状的嗜酸性粒细胞增多。有趣的是,在患者的药物换成戈利木单抗后,明显的嗜酸性粒细胞增多和皮肤症状未再次出现。在这种情况下,生物制剂特异性抗体的存在提示免疫原性导致了嗜酸性粒细胞增多。因此,换用免疫原性较低的生物制剂是有效的。这些发现可能有助于临床医生治疗生物制剂诱导的嗜酸性粒细胞增多症患者。