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英夫利昔单抗治疗肾移植后复发的复发性神经结节病:病例报告。

Infliximab for relapsing neurosarcoidosis recurring after kidney transplantation: a case report.

机构信息

Division of Nephrology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.

Division of Radiology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.

出版信息

Acta Clin Belg. 2021 Apr;76(2):149-151. doi: 10.1080/17843286.2019.1664093. Epub 2019 Sep 5.

Abstract

Neurological involvement of sarcoidosis is a rare condition, and its occurrence in the context of transplantation is exceptional. Moreover, treatment can be challenging. We report the unusual case of a patient transplanted with a kidney for end-stage renal disease secondary to sarcoidosis who experienced a neurological recurrence of the disease under immunosuppressive treatment, translating in behavioural aggressiveness, social withdrawal and weight loss. He relapsed thrice under corticosteroids but responded finally to infliximab. This case highlights the potential of sarcoidosis to recur neurologically after kidney transplantation despite immunosuppressive treatment. Also, treatment of relapsing neurosarcoidosis can be challenging and may benefit from TNF-α blockers.

摘要

结节病的神经系统受累是一种罕见的情况,在移植背景下发生则更为罕见。此外,治疗可能具有挑战性。我们报告了一例不常见的病例,一名因结节病导致终末期肾病的患者接受了肾脏移植,在免疫抑制治疗下,该患者出现了疾病的神经系统复发,表现为行为攻击性、社交退缩和体重减轻。他在皮质类固醇治疗下复发了三次,但最终对英夫利昔单抗有反应。这个病例突出表明,结节病在肾脏移植后尽管进行了免疫抑制治疗,仍有可能在神经系统中复发。此外,复发性神经结节病的治疗可能具有挑战性,并且可能受益于 TNF-α 阻滞剂。

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