一名8岁女童使用骨化三醇和帕立骨化醇成功治疗重度特应性皮炎

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl.

作者信息

Bothou Christina, Alexopoulos Alexis, Dermitzaki Eleni, Kleanthous Kleanthis, Papadimitriou Anastasios, Mastorakos George, Papadimitriou Dimitrios T

机构信息

Division of Endocrinology, Diabetes and Metabolism, Medical Department 1, University Hospital, Goethe University, Frankfurt am Main, Germany.

Pediatric Dermatology Clinic, 1st Department of Pediatrics, Aghia Sofia Children's Hospital, University of Athens, Athens, Greece.

出版信息

Case Rep Pediatr. 2018 Jun 24;2018:9643543. doi: 10.1155/2018/9643543. eCollection 2018.

Abstract

Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report, we present a girl with severe AD who under adequate supplementation with cholecalciferol was treated with calcitriol and subsequently with paricalcitol. She had significant improvement-almost healing of her skin lesions within 2 months, a result sustained for more than 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, treatment was continued with paricalcitol, a vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe, and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.

摘要

特应性皮炎(AD)是一种影响儿童和青少年的慢性炎症性疾病。AD的传统治疗方法,包括局部使用润肤剂和全身使用免疫调节剂,主要侧重于减轻皮肤炎症和恢复表皮屏障功能,但在许多情况下已被证明无效。多项研究表明,补充维生素D要么可降低患AD的风险,要么可改善AD患者的症状。在本报告中,我们介绍了一名患有重度AD的女孩,在充分补充胆钙化醇后,先后接受骨化三醇和帕立骨化醇治疗。她的病情有显著改善——皮肤病变在2个月内几乎痊愈,且这一结果持续至今已超过3年。由于骨化三醇治疗的副作用导致高钙尿症,因此继续使用帕立骨化醇进行治疗,帕立骨化醇是一种用于慢性肾病继发性甲状旁腺功能亢进的维生素D类似物。在监测可能的副作用情况下,可以认为骨化三醇治疗对重度AD患者,尤其是对难治性AD患者是一种安全有效的治疗选择。帕立骨化醇治疗可解决高钙尿症问题,且安全可靠,应作为特应性皮炎以及可能的其他自身免疫性疾病的替代治疗方法进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eab/6035840/598e386f0163/CRIPE2018-9643543.001.jpg

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