Padron Simonette, Rogers Everett, Demory Beckler Michelle, Kesselman Marc
Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA.
Department of Microbiology, Nova Southeastern University Health Professions Division, College of Medical Sciences, Fort Lauderdale, Florida, USA.
BMJ Case Rep. 2019 Aug 22;12(8):e228981. doi: 10.1136/bcr-2018-228981.
Sitagliptin is a dipeptidyl peptidase-4 inhibitor commonly used in the treatment of type 2 diabetes mellitus for glycaemic control. Concerns have arisen regarding adverse events caused by this drug, particularly concerning arthralgias. Here, we report on a 56-year-old man being treated with sitagliptin who developed inflammatory arthritis after taking the drug for 6 months. The patient presented with pain, swelling and erythema in multiple joints and was eventually diagnosed with seronegative rheumatoid arthritis (RA) under the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. His symptoms continued for several months after stopping sitagliptin and eventually went into remission after a tapered course of steroids, hydroxychloroquine and methotrexate. Furthermore, the patient is HLA-DRB3 positive, a genetic marker that is still being investigated for its role in the pathogenesis of RA and that may have been a predisposing factor in the development of this patient's inflammatory arthropathy.
西他列汀是一种二肽基肽酶-4抑制剂，常用于治疗2型糖尿病以控制血糖。人们对该药物引起的不良事件产生了担忧，尤其是关节痛。在此，我们报告一名56岁男性，他在服用西他列汀6个月后出现炎症性关节炎，正在接受西他列汀治疗。患者出现多个关节疼痛、肿胀和红斑，最终根据2010年美国风湿病学会/欧洲抗风湿病联盟分类标准被诊断为血清阴性类风湿关节炎（RA）。停用西他列汀后，他的症状持续了几个月，最终在逐渐减量使用类固醇、羟氯喹和甲氨蝶呤后病情缓解。此外，该患者HLA-DRB3呈阳性，这是一种仍在研究其在RA发病机制中的作用的基因标记，可能是该患者炎症性关节病发生的一个易感因素。
