Angeletti Andrea, Baraldi Olga, Chiocchini Anna Laura, Comai Giorgia, Cravedi Paolo, La Manna Gaetano
Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St Orsola Hospital, University of Bologna, Bologna, Italy.
Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, USA.
J Clin Case Rep. 2017;7(10). doi: 10.4172/2165-7920.10001033. Epub 2017 Oct 27.
Neuropsychiatric and renal involvement are common in systemic lupus erythematosus with negative impact on patient survival. Glucocorticoids, antiproliferative and cytotoxic agents represent first-line therapies, but are often ineffective and are burdened by significant toxicities. Despite the negative results of two randomized controlled trials, rituximab is still widely used as second- or third-line therapy in similar cases. No case has been reported so far where rituximab has been used as first-line therapy. We report the case of a 60-year-old cCaucasian woman with concurrent neuropsychiatric and renal lupus erythematous treated with one cycle of rituximab therapy at disease onset. Treatment was well tolerated and at 24 months the patient is in complete remission and free of immunosuppression. To the best of our knowledge, this is the first case of neuropsychiatric and renal lupus erythematosus successfully treated with rituximab as first-line therapy.
神经精神和肾脏受累在系统性红斑狼疮中很常见，对患者生存有负面影响。糖皮质激素、抗增殖和细胞毒性药物是一线治疗方法，但往往无效且伴有明显毒性。尽管两项随机对照试验结果为阴性，但利妥昔单抗仍广泛用作类似病例的二线或三线治疗。迄今为止，尚无利妥昔单抗用作一线治疗的病例报告。我们报告了一例60岁的白种女性，在疾病发作时接受了一个周期的利妥昔单抗治疗，同时患有神经精神性和肾性红斑狼疮。治疗耐受性良好，24个月时患者完全缓解且无需免疫抑制。据我们所知，这是首例以利妥昔单抗作为一线治疗成功治疗神经精神性和肾性红斑狼疮的病例。
