Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan.
Department of Pathology, Faculty of Medicine, Saitama Medical University, Japan.
Intern Med. 2023 Jun 1;62(11):1683-1689. doi: 10.2169/internalmedicine.9793-22. Epub 2022 Oct 26.
We encountered a 57-year-old Japanese woman with encapsulating peritoneal sclerosis (EPS) in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis. The patient was admitted to our hospital because of ascites retention. Administration of tocilizumab, an anti-interleukin-6 receptor antibody, for her RA reduced the refractory ascites remarkably; however, she developed sudden acute gastrointestinal bleeding and died a year later. On autopsy, sclerotic thickening of the peritoneum showed diffuse infiltration of podoplanin-positive fibroblast-like cells, and a diagnosis of EPS was made. EPS rarely occurs in SLE, and tocilizumab may be a new treatment candidate for EPS.
我们遇到一位 57 岁的日本女性,患有红斑狼疮(SLE)、类风湿关节炎(RA)和系统性硬化症相关的包裹性腹膜硬化症(EPS)。因腹水潴留,该患者被收入我院。托珠单抗(一种抗白细胞介素 6 受体抗体)治疗其 RA 后显著减少了难治性腹水;然而,她随后突发急性胃肠道出血,一年后死亡。尸检显示,腹膜硬化增厚表现为 podoplanin 阳性成纤维样细胞弥漫浸润,诊断为 EPS。SLE 中罕见发生 EPS,托珠单抗可能是 EPS 的一种新的治疗候选药物。