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低剂量环磷酰胺、利妥昔单抗、糖皮质激素及血浆置换治疗重症肉芽肿性多血管炎：一例报告

Severe Granulomatosis With Polyangiitis Treated With Low-Dose Cyclophosphamide, Rituximab, Glucocorticoids, and Plasma Exchange: A Case Report.

作者信息

Mira Michael, Ohonba Nosagie, Vayzband Vlad, Brown Ryan

机构信息

Internal Medicine, Overlook Medical Center, Summit, USA.

Nephrology, Overlook Medical Center, Summit, USA.

出版信息

Cureus. 2024 Jul 17;16(7):e64765. doi: 10.7759/cureus.64765. eCollection 2024 Jul.

DOI:10.7759/cureus.64765
PMID:39156418
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11329316/
Abstract

Granulomatosis with polyangiitis (GPA) is a systemic vasculitis that affects blood vessels and presents with vague constitutional symptoms, but more serious manifestations can develop, including pulmonary complications and glomerulonephritis. Currently, there are no definitive treatment guidelines. We present a case of a 66-year-old male with no previous medical history who was admitted for generalized constitutional symptoms for the past month. Imaging of the patient's brain revealed dural enhancement. Bronchoalveolar lavage was done and revealed diffuse alveolar hemorrhage (DAH). A kidney biopsy revealed granulomatosis with polyangiitis. The patient's hospital course was complicated by acute renal failure and required hemodialysis. Due to the patient's multi-organ involvement, the patient was treated aggressively with cyclophosphamide, rituximab, plasma exchange (PE), and steroids. GPA is a systemic vasculitis that can present with multi-organ involvement. A prompt diagnosis is necessary to initiate treatment and preserve organ function. More research is needed to determine which combination therapies are the best treatment modalities in cases of severe multi-organ system involvement.

摘要

肉芽肿性多血管炎（GPA）是一种影响血管的系统性血管炎，表现为模糊的全身症状，但也可能出现更严重的表现，包括肺部并发症和肾小球肾炎。目前，尚无明确的治疗指南。我们报告一例66岁男性患者，既往无病史，因过去一个月出现全身症状入院。患者脑部影像学检查显示硬脑膜强化。进行了支气管肺泡灌洗，结果显示弥漫性肺泡出血（DAH）。肾脏活检显示肉芽肿性多血管炎。患者的住院过程因急性肾衰竭而复杂化，需要进行血液透析。由于患者多器官受累，积极采用环磷酰胺、利妥昔单抗、血浆置换（PE）和类固醇进行治疗。GPA是一种可出现多器官受累的系统性血管炎。及时诊断对于启动治疗和保护器官功能至关重要。需要更多研究来确定在严重多器官系统受累的情况下，哪种联合治疗是最佳治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/099e818a5dee/cureus-0016-00000064765-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/504c6a0acd44/cureus-0016-00000064765-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/4ebcce86c814/cureus-0016-00000064765-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/cc25eeb595d2/cureus-0016-00000064765-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/dbd857801314/cureus-0016-00000064765-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/d3554b6883c0/cureus-0016-00000064765-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/099e818a5dee/cureus-0016-00000064765-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/504c6a0acd44/cureus-0016-00000064765-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/4ebcce86c814/cureus-0016-00000064765-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/cc25eeb595d2/cureus-0016-00000064765-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/dbd857801314/cureus-0016-00000064765-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/d3554b6883c0/cureus-0016-00000064765-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509a/11329316/099e818a5dee/cureus-0016-00000064765-i06.jpg

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本文引用的文献

1
Combination treatment with rituximab, low-dose cyclophosphamide and plasma exchange for severe antineutrophil cytoplasmic antibody-associated vasculitis.利妥昔单抗、低剂量环磷酰胺联合血浆置换治疗重症抗中性粒细胞胞浆抗体相关性血管炎。
Kidney Int. 2021 Dec;100(6):1316-1324. doi: 10.1016/j.kint.2021.08.025. Epub 2021 Sep 22.
2
KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases.KDIGO 2021肾小球疾病管理临床实践指南。
Kidney Int. 2021 Oct;100(4S):S1-S276. doi: 10.1016/j.kint.2021.05.021.
3
2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.
2021 年美国风湿病学会/血管炎基金会抗中性粒细胞胞浆抗体相关性血管炎治疗指南。
Arthritis Rheumatol. 2021 Aug;73(8):1366-1383. doi: 10.1002/art.41773. Epub 2021 Jul 8.
4
Renal Involvement in Granulomatosis With Polyangiitis Increases Economic Health Care Burden: Insights From the National Inpatient Sample Database.显微镜下多血管炎的肾脏受累增加了医疗保健经济负担：来自国家住院样本数据库的见解
Cureus. 2021 Jan 5;13(1):e12515. doi: 10.7759/cureus.12515.
5
ANCA-associated vasculitis.抗中性粒细胞胞浆抗体相关性血管炎。
Nat Rev Dis Primers. 2020 Aug 27;6(1):71. doi: 10.1038/s41572-020-0204-y.
6
Clinical associations of renal involvement in ANCA-associated vasculitis.肾血管炎相关抗中性粒细胞胞质抗体相关性血管炎的临床相关性。
Autoimmun Rev. 2020 Apr;19(4):102495. doi: 10.1016/j.autrev.2020.102495. Epub 2020 Feb 15.
7
Anti-neutrophil cytoplasmic antibody-associated vasculitis: prevalence, treatment, and outcomes.抗中性粒细胞胞浆抗体相关性血管炎：患病率、治疗和结局。
Rheumatol Int. 2017 Nov;37(11):1779-1788. doi: 10.1007/s00296-017-3818-y. Epub 2017 Sep 27.
8
2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides.2012年修订的国际 Chapel Hill 共识会议血管炎命名法
Arthritis Rheum. 2013 Jan;65(1):1-11. doi: 10.1002/art.37715.
9
Pathogenesis of ANCA-associated vasculitis.抗中性粒细胞胞质抗体相关性血管炎的发病机制。
Rheum Dis Clin North Am. 2010 Aug;36(3):463-77. doi: 10.1016/j.rdc.2010.05.006. Epub 2010 Jun 23.