Division of Rheumatology, Kurume University Medical Center, Kurume, Japan.
Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Mod Rheumatol Case Rep. 2023 Jun 19;7(2):448-452. doi: 10.1093/mrcr/rxac090.
A 17-year-old woman was referred to our department with fever, general malaise, and weight loss. She was diagnosed with Takayasu arteritis (TAK) and Crohn's disease (CD) following positron emission tomography-computed tomography (PET-CT) and colonoscopy, respectively. Serological human leukocyte antigen (HLA) typing revealed HLA-B52 positivity. Initial treatment with prednisolone (PSL) (0.5 mg/kg) was insufficient; therefore, ustekinumab and 5-aminosalicylic acid were added. This treatment achieved PSL-free remission for both diseases, as confirmed by PET-CT and colonoscopy. Although treatment guidelines for TAK and CD have been previously established, treatment of patients with TAK with coexisting CD is controversial. Our case suggests that ustekinumab has the ability to achieve TAK remission in addition to its therapeutic effect on CD.
一位 17 岁女性因发热、全身不适和体重减轻被转至我科。经正电子发射断层扫描-计算机断层扫描(PET-CT)和结肠镜检查,分别诊断为 Takayasu 动脉炎(TAK)和克罗恩病(CD)。血清人类白细胞抗原(HLA)分型显示 HLA-B52 阳性。泼尼松龙(PSL)(0.5mg/kg)初始治疗效果不佳;因此,添加了乌司奴单抗和 5-氨基水杨酸。PET-CT 和结肠镜检查证实,这两种药物的联合治疗使两种疾病均达到 PSL 缓解。尽管先前已经制定了 TAK 和 CD 的治疗指南,但同时患有 TAK 和 CD 的患者的治疗仍存在争议。我们的病例表明,乌司奴单抗除了对 CD 有治疗作用外,还有使 TAK 缓解的能力。