Nishikawa Mana, Shimada Noriaki, Kawazoe Tomohiro, Sawaki Ryo, Ikuta Haruka, Kanzaki Motoko, Fukuoka Kosuke, Fukushima Masaki, Asano Kenichiro
Department of Nephrology, Kurashiki Central Hospital, Japan.
Department of Internal Medicine, Shigei Research Institute Hospital, Japan.
Intern Med. 2020 Apr 1;59(7):983-986. doi: 10.2169/internalmedicine.3837-19. Epub 2019 Dec 20.
A 22-year-old woman had been diagnosed with idiopathic thrombocytopenic purpura (ITP) 5 years earlier. After undergoing splenectomy, she relapsed frequently following prednisolone tapering. She was complicated with minimal change nephrotic syndrome (MCNS) while taking 20 mg of prednisolone. Despite treatment with prednisolone, cyclosporin and low-density lipoprotein-apheresis, MCNS and ITP did not improve. We added rituximab in 4 weekly infusions of 375 mg/m. MCNS and ITP were in complete remission. After administering rituximab once, all medicines were discontinued. No relapse had occurred by 50 months following the first rituximab administration. Rituximab affects steroid-resistant MCNS and ITP for a long time without complications.
一名22岁女性5年前被诊断为特发性血小板减少性紫癜（ITP）。脾切除术后，在泼尼松龙逐渐减量时她频繁复发。在服用20mg泼尼松龙期间，她并发了微小病变肾病综合征（MCNS）。尽管使用泼尼松龙、环孢素和低密度脂蛋白去除术进行治疗，MCNS和ITP仍未改善。我们加入了利妥昔单抗，以375mg/m的剂量进行4次每周一次的输注。MCNS和ITP完全缓解。在给予一次利妥昔单抗后，所有药物均停用。首次给予利妥昔单抗后50个月未发生复发。利妥昔单抗可长期影响激素抵抗性MCNS和ITP，且无并发症。
