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使用利妥昔单抗治疗后，类风湿关节炎相关支气管扩张出现显著恶化。

Marked deterioration in rheumatoid arthritis associated bronchiectasis following treatment with Rituximab.

作者信息

Musameh K, Campbell C D, Rutherford R M

机构信息

Department of Respiratory Medicine, University Hospital Galway, Galway, Ireland.

出版信息

Respir Med Case Rep. 2019 Jul 11;28:100904. doi: 10.1016/j.rmcr.2019.100904. eCollection 2019.

DOI:10.1016/j.rmcr.2019.100904
PMID:31360633
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6639681/
Abstract

We report a 67 year old lady with Rheumatoid Arthritis (RA) and mild bronchiectasis (BE) whose treatment was escalated to Rituximab. Nine months after commencing Rituximab her lung sepsis worsened dramatically with repeated hospitalization, new sputum isolation of and and marked radiological deterioration in BE. She was found to have a low serum IgG and IgM levels almost certainly as a complication of Rituximab. Immunoglobulin replacement therapy was instituted and her clinical status has slowly improved.

摘要

我们报告了一位67岁患有类风湿性关节炎（RA）和轻度支气管扩张（BE）的女性患者，其治疗方案升级为使用利妥昔单抗。在开始使用利妥昔单抗九个月后，她的肺部脓毒症急剧恶化，反复住院，新的痰液中分离出……，并且支气管扩张的影像学表现明显恶化。几乎可以肯定，她血清中的免疫球蛋白G（IgG）和免疫球蛋白M（IgM）水平较低是利妥昔单抗的并发症。于是开始进行免疫球蛋白替代疗法，她的临床状况已慢慢改善。 （原文中“新的痰液中分离出……”处内容不完整）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f23/6639681/fdecbd1f9712/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f23/6639681/3510a983d217/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f23/6639681/fdecbd1f9712/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f23/6639681/3510a983d217/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f23/6639681/fdecbd1f9712/gr2.jpg

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Marked deterioration in rheumatoid arthritis associated bronchiectasis following treatment with Rituximab.使用利妥昔单抗治疗后，类风湿关节炎相关支气管扩张出现显著恶化。
Respir Med Case Rep. 2019 Jul 11;28:100904. doi: 10.1016/j.rmcr.2019.100904. eCollection 2019.
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Clin Rheumatol. 2017 Dec;36(12):2743-2750. doi: 10.1007/s10067-017-3848-6. Epub 2017 Oct 4.

本文引用的文献

1
Practical Management of Respiratory Comorbidities in Patients with Rheumatoid Arthritis.类风湿关节炎患者呼吸合并症的实际管理
Rheumatol Ther. 2017 Dec;4(2):309-332. doi: 10.1007/s40744-017-0071-5. Epub 2017 Aug 14.
2
Bronchiectasis Rheumatoid Overlap Syndrome Is an Independent Risk Factor for Mortality in Patients With Bronchiectasis: A Multicenter Cohort Study.支气管扩张症-类风湿关节炎重叠综合征是支气管扩张症患者死亡的独立危险因素：一项多中心队列研究
Chest. 2017 Jun;151(6):1247-1254. doi: 10.1016/j.chest.2016.12.024. Epub 2017 Jan 16.
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Comorbidities and the risk of mortality in patients with bronchiectasis: an international multicentre cohort study.
支气管扩张症患者的合并症与死亡率风险：一项国际多中心队列研究。
Lancet Respir Med. 2016 Dec;4(12):969-979. doi: 10.1016/S2213-2600(16)30320-4. Epub 2016 Nov 16.
4
Prevalence and risk factors of asymptomatic bronchiectasis in patients with rheumatoid arthritis at a tertiary care center in Saudi Arabia.沙特阿拉伯一家三级医疗中心类风湿关节炎患者无症状支气管扩张的患病率及危险因素
Ann Thorac Med. 2015 Jul-Sep;10(3):176-80. doi: 10.4103/1817-1737.160836.
5
Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co-existent bronchiectasis.患有并存支气管扩张症的类风湿关节炎患者疾病活动度增加、严重程度增加且自身抗体阳性。
Int J Rheum Dis. 2017 Dec;20(12):2003-2011. doi: 10.1111/1756-185X.12702. Epub 2015 Jul 22.
6
RA autoantibodies as predictors of rheumatoid arthritis in non-cystic fibrosis bronchiectasis patients.类风湿性关节炎自身抗体作为非囊性纤维化支气管扩张症患者类风湿性关节炎的预测指标
Eur Respir J. 2014 Oct;44(4):1082-5. doi: 10.1183/09031936.00064014. Epub 2014 Jun 25.
7
Bronchiectasis in systemic diseases.全身性疾病中的支气管扩张症
Chest. 1999 Oct;116(4):1063-74. doi: 10.1378/chest.116.4.1063.
8
Bronchiectasis and rheumatoid disease: is there an association?支气管扩张症与类风湿病：二者有关联吗？
Br J Rheumatol. 1992 Oct;31(10):691-3. doi: 10.1093/rheumatology/31.10.691.