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在一名即将发生重症肌无力危象的患者中加用艾加莫德进行抢救治疗:一例病例报告

Rescue treatment with add-on efgartigimod in a patient with impending myasthenic crisis: a case report.

作者信息

Zhang Zhouao, Yang Mingjin, Luo Tiancheng, Du Xue, Wang Zhouyi, Huang Xiaoyu, Zhang Yong

机构信息

Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Department of Neurology, Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu 210000, China.

出版信息

Ther Adv Neurol Disord. 2024 May 28;17:17562864241254895. doi: 10.1177/17562864241254895. eCollection 2024.

Abstract

Myasthenia gravis (MG) is an autoimmune disorder characterized by fluctuating muscle weakness. Severe patients may develop life-threatening respiratory failure and experience crisis. Plasma exchange or intravenous immunoglobulin (IVIg) is the first-line treatment option for myasthenia crisis, but some patients still poorly respond to them. Here, we first reported a generalized MG patient from China who was in a state of impending myasthenic crisis and did not respond effectively to IVIg but was successfully rescued by add-on efgartigimod. Especially, we also detected meaningful changes in T-cell and B-cell subsets after efgartigimod, promoting a potential role of efgartigimod in re-establishing immune homeostasis.

摘要

重症肌无力(MG)是一种自身免疫性疾病,其特征为肌肉无力波动。严重患者可能会发展为危及生命的呼吸衰竭并经历危象。血浆置换或静脉注射免疫球蛋白(IVIg)是重症肌无力危象的一线治疗选择,但一些患者对其反应仍不佳。在此,我们首次报道了一名来自中国的全身型MG患者,该患者处于重症肌无力危象前期状态,对IVIg无有效反应,但通过加用艾加莫德成功获救。特别是,我们还检测到艾加莫德治疗后T细胞和B细胞亚群有意义的变化,提示艾加莫德在重建免疫稳态中可能发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ad6/11135074/74d7ce18ed00/10.1177_17562864241254895-fig1.jpg

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