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采用利妥昔单抗进行 B 细胞耗竭疗法诱导亚急性皮肤型红斑狼疮顽固皮损的长期缓解。

B cell depletion therapy using rituximab to induce long-term remission of recalcitrant skin lesions of subacute cutaneous lupus erythematosus.

机构信息

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Department of Pathology, All India Institute of Medical Sciences, New Delhi, New Delhi, Delhi, India.

出版信息

BMJ Case Rep. 2022 May 27;15(5):e248476. doi: 10.1136/bcr-2021-248476.

DOI:10.1136/bcr-2021-248476
PMID:35623653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9150159/
Abstract

A woman in her 20s presented with chilblains for 2 years and recent-onset photodistributed psoriasiform plaques. She did not have persistent good improvement despite treatment with 1 mg/kg oral prednisolone, along with successive trials with many steroid-sparing adjuvants in adequate dosage and duration, including hydroxychloroquine, methotrexate and cyclosporine, in the following 6 months. The patient had an excellent improvement and went into remission with two doses of injection rituximab, 1 g each, at a 2-week interval. The remission was maintained during the 14-month follow-up.

摘要

一位 20 多岁的女性,因冻疮样疹 2 年,近期出现光分布的银屑病样斑块就诊。尽管给予 1mg/kg 口服泼尼松龙治疗,并在接下来的 6 个月内连续尝试多种足量和足够疗程的类固醇助减剂,包括羟氯喹、甲氨蝶呤和环孢素,但病情持续无明显改善。患者在接受两次间隔 2 周、每次 1g 的注射用利妥昔单抗治疗后,皮损得到显著改善并进入缓解期,在 14 个月的随访期间病情保持缓解。

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本文引用的文献

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British Association of Dermatologists guidelines for the management of people with cutaneous lupus erythematosus 2021.英国皮肤科医师协会2021年皮肤红斑狼疮患者管理指南
Br J Dermatol. 2021 Dec;185(6):1112-1123. doi: 10.1111/bjd.20597. Epub 2021 Oct 19.
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2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus.2019 年欧洲抗风湿病联盟/美国风湿病学会系统性红斑狼疮分类标准。
Arthritis Rheumatol. 2019 Sep;71(9):1400-1412. doi: 10.1002/art.40930. Epub 2019 Aug 6.
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2019 update of the EULAR recommendations for the management of systemic lupus erythematosus.2019 年更新版的 EULAR 系统性红斑狼疮治疗建议。
Ann Rheum Dis. 2019 Jun;78(6):736-745. doi: 10.1136/annrheumdis-2019-215089. Epub 2019 Mar 29.
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Assessment of Response to B-Cell Depletion Using Rituximab in Cutaneous Lupus Erythematosus.评估利妥昔单抗治疗红斑狼疮皮肤病变的 B 细胞耗竭反应。
JAMA Dermatol. 2018 Dec 1;154(12):1432-1440. doi: 10.1001/jamadermatol.2018.3793.
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Rituximab in the treatment of extensive and refractory subacute cutaneous lupus erythematosus.利妥昔单抗治疗广泛性难治性亚急性皮肤型红斑狼疮
An Bras Dermatol. 2018 Jun;93(3):467-469. doi: 10.1590/abd1806-4841.20187561.
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Successful treatment of severe subacute cutaneous lupus erythematosus with rituximab in an adolescent.利妥昔单抗成功治疗一名青少年重度亚急性皮肤型红斑狼疮
Pediatr Dermatol. 2018 May;35(3):e189-e190. doi: 10.1111/pde.13442. Epub 2018 Mar 23.
7
The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults.英国风湿病学会成人系统性红斑狼疮管理指南。
Rheumatology (Oxford). 2018 Jan 1;57(1):e1-e45. doi: 10.1093/rheumatology/kex286.
8
Using the American College of Rheumatology (ACR) and Systemic Lupus International Collaborating Clinics (SLICC) criteria to determine the diagnosis of systemic lupus erythematosus (SLE) in patients with subacute cutaneous lupus erythematosus (SCLE).采用美国风湿病学会(ACR)和系统性红斑狼疮国际协作诊所(SLICC)的标准来确定亚急性皮肤型红斑狼疮(SCLE)患者的系统性红斑狼疮(SLE)诊断。
J Am Acad Dermatol. 2016 May;74(5):862-9. doi: 10.1016/j.jaad.2015.12.029. Epub 2016 Feb 18.
9
Brief report: responses to rituximab suggest B cell-independent inflammation in cutaneous systemic lupus erythematosus.简要报告:利妥昔单抗治疗反应提示皮肤型系统性红斑狼疮中存在 B 细胞非依赖性炎症。
Arthritis Rheumatol. 2015 Jun;67(6):1586-91. doi: 10.1002/art.39085.
10
Current role of rituximab in systemic lupus erythematosus.利妥昔单抗在系统性红斑狼疮中的当前作用。
Int J Rheum Dis. 2015 Feb;18(2):154-63. doi: 10.1111/1756-185X.12463. Epub 2014 Dec 19.