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阿达木单抗治疗后肠道白塞病患者回肠造口成功闭合:一例报告

Successful closure of ileostomy in a patient with intestinal Behçet's disease after therapy with adalimumab: A case report.

作者信息

Yan Zhe, Cui Bei-Bei, Yu Yong-Yang, Yin Geng, Cen Xiao-Min, Xie Qi-Bing

机构信息

Department of Endocrinology and Metabolism.

Department of Rheumatology and Immunology.

出版信息

Medicine (Baltimore). 2019 Mar;98(9):e14624. doi: 10.1097/MD.0000000000014624.

Abstract

RATIONALE

Behçet's disease (BD) is a chronic immune-mediated inflammatory disorder involving multiple organ systems. In BD, intestinal ulcers can present as a refractory lesion capable of perforation, which makes the choice of treatment difficult.

PATIENT CONCERNS

A 34-year-old male who was diagnosed with intestinal BD and suffered with an ileocecal perforation. He underwent surgery for an ileostomy and was given corticosteroids as treatment. However, the ulcerative lesion remained resistant to the therapy that was provided which delayed the closure operation.

DIAGNOSIS

Intestinal BD with severe post-operative complication.

INTERVENTIONS

A course of adalimumab (ADa) therapy was started. Subsequently surgery was performed. And ADa and thalidomide were used as a maintenance therapy.

OUTCOMES

In this case, a course of ADa therapy was given which healed the intestinal ulcers and allowed us to successfully perform the closure operation.

LESSONS

This case indicates that ADa may be an effective treatment option in future cases, minimizing complications and allowing the closure operation to be performed successfully.

摘要

原理

白塞病(BD)是一种涉及多个器官系统的慢性免疫介导的炎症性疾病。在白塞病中,肠道溃疡可表现为能够穿孔的难治性病变,这使得治疗选择变得困难。

患者情况

一名34岁男性,被诊断为肠道白塞病并患有回盲部穿孔。他接受了回肠造口术,并接受了皮质类固醇治疗。然而,溃疡性病变对所提供的治疗仍有抵抗,这延迟了闭合手术。

诊断

肠道白塞病伴严重术后并发症。

干预措施

开始使用阿达木单抗(ADa)治疗疗程。随后进行了手术。并使用ADa和沙利度胺作为维持治疗。

结果

在本病例中,给予一个疗程的ADa治疗,治愈了肠道溃疡,并使我们成功进行了闭合手术。

经验教训

该病例表明,ADa在未来病例中可能是一种有效的治疗选择,可将并发症降至最低,并使闭合手术得以成功进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3a0/6831344/12618e5799d1/medi-98-e14624-g001.jpg

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