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托珠单抗和重组血栓调节蛋白成功治疗伴弥散性血管内凝血的TAFRO综合征

TAFRO Syndrome with Disseminated Intravascular Coagulation Successfully Treated with Tocilizumab and Recombinant Thrombomodulin.

作者信息

Takayama Yusuke, Kubota Tetsuya, Ogino Yoshitaka, Ohnishi Hiroshi, Togitani Kazuto, Yokoyama Akihito

机构信息

Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Japan.

出版信息

Intern Med. 2018 May 1;57(9):1291-1296. doi: 10.2169/internalmedicine.9484-17. Epub 2017 Dec 27.

Abstract

TAFRO syndrome is a systemic inflammatory disorder that is characterized by thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly. Although thrombocytopenia is one of the major features of TAFRO syndrome, complications of disseminated intravascular coagulation (DIC) are not common. The therapeutic strategy for TAFRO syndrome complicated by DIC has not been established. We herein describe a case of TAFRO syndrome with DIC that was successfully treated with tocilizumab (an anti-IL-6 receptor antibody) and recombinant thrombomodulin (rTM). This case suggests a possible therapeutic benefit of rTM in patients with TAFRO syndrome complicated by DIC.

摘要

TAFRO综合征是一种全身性炎症性疾病,其特征为血小板减少、全身性水肿、骨髓纤维化、肾功能不全和脏器肿大。虽然血小板减少是TAFRO综合征的主要特征之一,但弥散性血管内凝血(DIC)并发症并不常见。TAFRO综合征合并DIC的治疗策略尚未确立。我们在此描述一例TAFRO综合征合并DIC的病例,该病例通过托珠单抗(一种抗IL-6受体抗体)和重组血栓调节蛋白(rTM)成功治愈。该病例提示rTM对TAFRO综合征合并DIC患者可能具有治疗益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09a1/5980813/1588f534cb8e/1349-7235-57-1291-g001.jpg

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