Czerminski Jan, Khatri Supriya, Rao Balaji
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Queen's University School of Medicine, Kingston, ON, Canada.
Emerg Radiol. 2024 Dec;31(6):937-941. doi: 10.1007/s10140-024-02286-2. Epub 2024 Sep 27.
Since the 2021 FDA approval of the first monoclonal antibody (MAB) therapy for Alzheimer's disease (AD), treatment has progressed from symptom management to targeting and reducing amyloid β plaque burden. While these therapies offer hope of altering the disease course, they come with risks, such as amyloid-related imaging abnormalities (ARIA), which include ARIA-E (edema and effusion) and ARIA-H (hemorrhage). This report details the case of a 64-year-old woman undergoing donanemab treatment who developed severe ARIA, characterized by extensive vasogenic edema and multiple microhemorrhages. The increasing use of MABs necessitates heightened awareness and expertise among emergency radiologists to identify findings of ARIA effectively, ensuring timely and appropriate care for patients undergoing these novel therapies.
自2021年美国食品药品监督管理局(FDA)批准首款用于治疗阿尔茨海默病(AD)的单克隆抗体(MAB)疗法以来,治疗已从症状管理发展到针对并减轻淀粉样β斑块负担。虽然这些疗法为改变疾病进程带来了希望,但它们也伴随着风险,如淀粉样蛋白相关成像异常(ARIA),其中包括ARIA-E(水肿和积液)和ARIA-H(出血)。本报告详细介绍了一名接受多奈单抗治疗的64岁女性的病例,该患者出现了严重的ARIA,其特征为广泛的血管源性水肿和多处微出血。MABs的使用日益增加,这就要求急诊放射科医生提高认识并具备专业知识,以便有效地识别ARIA的表现,确保为接受这些新型疗法的患者提供及时、恰当的治疗。