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利妥昔单抗用于难治性抗3-羟基-3-甲基戊二酰辅酶A还原酶免疫介导的坏死性肌病:一例报告。

Rituximab use for refractory anti-HMGCR immune-mediated necrotizing myopathy: A case report.

作者信息

Gupta Sonia, Rakhra Amandeep, Thallapally Vinay, Nahas Joseph

机构信息

Department of Internal Medicine, Creighton University, Omaha, Nebraska, USA.

Department of Rheumatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.

出版信息

Intractable Rare Dis Res. 2021 May;10(2):122-125. doi: 10.5582/irdr.2020.03144.

DOI:10.5582/irdr.2020.03144
PMID:33996358
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8122313/
Abstract

Immunosuppression is the cornerstone therapy for anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy. Typical immunosuppressants such as corticosteroids, methotrexate, and azathioprine have been used in conjunction with removal of the offending agent, yet the use of rituximab is more limited in this type of myopathy. Reported here is a case of a patient who responded well to rituximab (RTX) after the standard immunosuppressants had failed. This case illustrates the importance of further studies to evaluate the role of RTX in anti-HMGCR myopathy.

摘要

免疫抑制是抗3-羟基-3-甲基戊二酰辅酶A还原酶(抗HMGCR)肌病的基石疗法。典型的免疫抑制剂,如皮质类固醇、甲氨蝶呤和硫唑嘌呤,已与去除致病因素联合使用,但利妥昔单抗在这类肌病中的应用更为有限。本文报告了1例患者,在标准免疫抑制剂治疗失败后,对利妥昔单抗(RTX)反应良好。该病例说明了进一步研究以评估RTX在抗HMGCR肌病中作用的重要性。

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本文引用的文献

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Anti-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibody in necrotizing myopathy: treatment outcomes, cancer risk, and role of autoantibody level.抗羟甲基戊二酰辅酶 A 还原酶(anti-HMGCR)抗体在坏死性肌病中的作用:治疗结果、癌症风险及自身抗体水平的作用。
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Rituximab in the Treatment of Refractory Anti-HMGCR Immune-mediated Necrotizing Myopathy.利妥昔单抗治疗难治性抗 HMGCR 免疫介导的坏死性肌病。
J Rheumatol. 2019 Jun;46(6):623-627. doi: 10.3899/jrheum.171495. Epub 2018 Dec 15.
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A Case of Atorvastatin-Associated Necrotizing Autoimmune Myopathy, Mimicking Idiopathic Polymyositis.一例阿托伐他汀相关的坏死性自身免疫性肌病,酷似特发性多肌炎。
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224th ENMC International Workshop:: Clinico-sero-pathological classification of immune-mediated necrotizing myopathies Zandvoort, The Netherlands, 14-16 October 2016.第224届ENMC国际研讨会:免疫介导性坏死性肌病的临床-血清学-病理学分类,荷兰赞德福特,2016年10月14日至16日。
Neuromuscul Disord. 2018 Jan;28(1):87-99. doi: 10.1016/j.nmd.2017.09.016. Epub 2017 Oct 23.
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An Unusual Case of Statin-Induced Myopathy: Anti-HMGCoA Necrotizing Autoimmune Myopathy.他汀类药物诱导的肌病罕见病例:抗HMGCoA坏死性自身免疫性肌病
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