Servicio de Neurología Hospital Universitario La Paz, Spain.
Servicio de Neurología Hospital Universitario La Paz, Spain.
Neurologia (Engl Ed). 2023 Sep;38(7):463-466. doi: 10.1016/j.nrleng.2021.01.005.
Late-onset neutropaenia is defined as an absolute neutrophil count of <1.5×10cells/μL starting>4 weeks after the last dose of rituximab, in the absence of other identifiable causes. Late-onset neutropaenia is a rare adverse reaction to rituximab (observed in approximately 5% of patients). Rheumatic diseases constitute the main indication for rituximab; in these patients, neutropaenia appears after a mean of>28 days. Ocrelizumab is another monoclonal antibody that binds to CD20 (a glycosylated phosphoprotein mainly expressed on the membranes of B-lymphocytes); in January 2018, it was approved for the treatment of relapsing-remitting and primary progressive multiple sclerosis. We present a case of neutropaenia following intravenous infusion of ocrelizumab in a patient with primary progressive multiple sclerosis who presented with neutropaenic fever, herpetic stomatitis, and ecthyma gangrenosum only 20 days after infusion.
迟发性中性粒细胞减少症的定义为在最后一次利妥昔单抗给药后 4 周以上，在没有其他可识别原因的情况下，绝对中性粒细胞计数<1.5×10^9 个/μL。迟发性中性粒细胞减少症是利妥昔单抗的一种罕见不良反应（约 5%的患者观察到）。风湿性疾病是利妥昔单抗的主要适应证；在这些患者中，中性粒细胞减少症出现在平均>28 天后。奥瑞珠单抗是另一种与 CD20 结合的单克隆抗体（一种主要表达在 B 淋巴细胞膜上的糖基化磷蛋白）；2018 年 1 月，它被批准用于治疗复发缓解型和原发性进行性多发性硬化症。我们报告了一例原发性进行性多发性硬化症患者在静脉输注奥瑞珠单抗后发生中性粒细胞减少症的病例，该患者在输注后仅 20 天就出现中性粒细胞减少性发热、疱疹性口炎和坏疽性脓皮病。
