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利妥昔单抗相关的无已知病毒再激活的肝毒性

Rituximab-Associated Liver Toxicity Without Known Viral Reactivation.

作者信息

Huda Taha, Hussain Fawaz, Mani Hariharasudan, Gheith Shereen M, Skandan Savitri

机构信息

Internal Medicine, HCA Florida Bayonet Point Hospital, Hudson, USA.

Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.

出版信息

Cureus. 2024 Jul 11;16(7):e64331. doi: 10.7759/cureus.64331. eCollection 2024 Jul.

DOI:10.7759/cureus.64331
PMID:39130968
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11316497/
Abstract

Rituximab is a targeted immunotherapeutic agent that has demonstrated efficacy in treating CD20+ B-cell neoplasms as well as other lymphoproliferative and autoimmune disorders. A major adverse effect of rituximab is hepatocellular injury attributed to hepatitis B viral reactivation, necessitating viral titers before treatment. In this case report, we illustrate the rare presentation of a patient with marginal zone B-cell lymphoma who experienced symptomatic liver injury with a peak 15-fold aminotransferase elevation following his first dose of rituximab, without evidence of viral reactivation.

摘要

利妥昔单抗是一种靶向免疫治疗药物，已证明在治疗CD20+ B细胞肿瘤以及其他淋巴增殖性疾病和自身免疫性疾病方面有效。利妥昔单抗的一个主要不良反应是由乙型肝炎病毒再激活引起的肝细胞损伤，因此在治疗前需要检测病毒滴度。在本病例报告中，我们阐述了一名边缘区B细胞淋巴瘤患者的罕见表现，该患者在首次注射利妥昔单抗后出现有症状的肝损伤，转氨酶峰值升高了15倍，且无病毒再激活的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/39a693286b7c/cureus-0016-00000064331-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/97b2cf0899f7/cureus-0016-00000064331-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/f14bfa08fda8/cureus-0016-00000064331-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/39a693286b7c/cureus-0016-00000064331-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/97b2cf0899f7/cureus-0016-00000064331-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/f14bfa08fda8/cureus-0016-00000064331-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/412d/11316497/39a693286b7c/cureus-0016-00000064331-i03.jpg

相似文献

1
Rituximab-Associated Liver Toxicity Without Known Viral Reactivation.利妥昔单抗相关的无已知病毒再激活的肝毒性
Cureus. 2024 Jul 11;16(7):e64331. doi: 10.7759/cureus.64331. eCollection 2024 Jul.
2
High titers of anti-HBs prevent rituximab-related viral reactivation in resolved hepatitis B patient with non-Hodgkin's lymphoma.高滴度抗-HBs 可预防已缓解乙型肝炎患者非霍奇金淋巴瘤患者接受利妥昔单抗治疗相关的病毒再激活。
J Med Virol. 2016 Jun;88(6):1010-7. doi: 10.1002/jmv.24423. Epub 2015 Nov 13.
3
Reactivation of hepatitis B virus after rituximab-containing treatment in patients with CD20-positive B-cell lymphoma.利妥昔单抗治疗后 CD20 阳性 B 细胞淋巴瘤患者乙型肝炎病毒再激活。
Cancer. 2010 Oct 15;116(20):4769-76. doi: 10.1002/cncr.25253.
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[Hepatitis B virus reactivation in rituximab-treated patients: incidence and risk factors].[利妥昔单抗治疗患者中的乙型肝炎病毒再激活：发病率及危险因素]
Gastroenterol Hepatol. 2015 Jan;38(1):1-6. doi: 10.1016/j.gastrohep.2014.05.008. Epub 2014 Sep 7.
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A Case of Rituximab-Induced Acute Thrombocytopenia in a Patient with Splenic Marginal Zone Lymphoma and Chronic Hepatitis C Virus Infection.1例利妥昔单抗诱导的脾边缘区淋巴瘤合并慢性丙型肝炎病毒感染患者急性血小板减少症
Am J Case Rep. 2019 Sep 21;20:1394-1397. doi: 10.12659/AJCR.917644.
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Rituximab-induced autoimmune hepatitis: A case study and literature review.利妥昔单抗诱导的自身免疫性肝炎：一例病例研究及文献综述。
Can Liver J. 2020 Nov 17;3(4):381-386. doi: 10.3138/canlivj-2020-0009. eCollection 2020 Fall.
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Lymphoproliferative Disease and Hepatitis B Reactivation: Challenges in the Era of Rapidly Evolving Targeted Therapy.淋巴增殖性疾病与乙型肝炎再激活：快速发展的靶向治疗时代的挑战
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A study of hepatitis B virus reactivation associated with rituximab therapy in real-world clinical practice: a single-center experience.一项真实世界临床实践中利妥昔单抗治疗相关乙型肝炎病毒再激活的研究：单中心经验。
Clin Mol Hepatol. 2013 Mar;19(1):51-9. doi: 10.3350/cmh.2013.19.1.51. Epub 2013 Mar 25.
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Hepatitis C virus - associated B cell non-Hodgkin's lymphoma.丙型肝炎病毒相关B细胞非霍奇金淋巴瘤
World J Gastroenterol. 2016 Jul 21;22(27):6214-23. doi: 10.3748/wjg.v22.i27.6214.

本文引用的文献

1
Rituximab-induced autoimmune hepatitis: A case study and literature review.利妥昔单抗诱导的自身免疫性肝炎：一例病例研究及文献综述。
Can Liver J. 2020 Nov 17;3(4):381-386. doi: 10.3138/canlivj-2020-0009. eCollection 2020 Fall.
2
RECAM: A New and Improved, Computerized Causality Assessment Tool for DILI Diagnosis.RECAM：一种用于药物性肝损伤诊断的全新且经过改进的计算机化因果关系评估工具。
Am J Gastroenterol. 2022 Sep 1;117(9):1387-1389. doi: 10.14309/ajg.0000000000001836. Epub 2022 May 25.
3
Rituximab-related reversible hepatocellular damage.
利妥昔单抗相关的可逆性肝细胞损伤。
Turk J Haematol. 2012 Dec;29(4):422-4. doi: 10.5505/tjh.2012.98853. Epub 2012 Dec 5.
4
Cholestatic liver disease after rituximab and adalimumab and the possible role of cross-reacting antibodies to Fab 2 fragments.利妥昔单抗和阿达木单抗治疗后出现的胆汁淤积性肝病以及针对Fab 2片段的交叉反应性抗体的可能作用。
PLoS One. 2013 Nov 11;8(11):e78856. doi: 10.1371/journal.pone.0078856. eCollection 2013.
5
A case of rituximab-induced hepatitis.利妥昔单抗诱导的肝炎病例。
Cancer Biother Radiopharm. 2010 Dec;25(6):747-8. doi: 10.1089/cbr.2010.0806.
6
Rituximab-induced acute liver failure after an allogeneic transplantation for chronic myeloid leukemia.利妥昔单抗诱导的慢性髓性白血病异基因移植后急性肝衰竭
Am J Hematol. 2005 Sep;80(1):43-5. doi: 10.1002/ajh.20413.