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罗沙司他联合免疫抑制剂治疗合并肾损伤的纯红细胞再生障碍性贫血

Roxadustat combined with immunosuppressants for treatment of pure red cell aplasia with kidney injury.

作者信息

Fan Lulu, Cao Lujia, Luo Yangyan, Gao Fang

机构信息

The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.

出版信息

Ann Hematol. 2024 Dec;103(12):5925-5927. doi: 10.1007/s00277-024-06053-8. Epub 2024 Oct 27.

Abstract

Pure red cell aplasia is a rare condition that may be congenital or associated with an underlying disease.Immunosuppressants are a commonly employed therapeutic option for the treatment of pure red cell aplasia;however, they are associated with considerable adverse effects, including nephrotoxicity. This case report describesa 74-year-old patient with pure red cell aplasia who developed long-term kidney injury following cyclosporinetherapy. Renal anemia is a common complication after chronic kidney injury and contributes to the poor outcome ofanemia treatment. Following a series of medication adjustments, the final treatment with roxarestat combined withsirolimus proved effective in delaying the impairment of this patient's kidney function, with the hemoglobin levelremaining above 100 g/L throughout. This case report demonstrates the efficacy of roxarestat in conjunction with animmunosuppressive agent in the treatment of pure red cell aplasia combined with kidney injury, with a dual effect ofalleviating the anemia and reducing serum creatinine levels.

摘要

纯红细胞再生障碍性贫血是一种罕见的疾病,可能是先天性的,也可能与潜在疾病有关。免疫抑制剂是治疗纯红细胞再生障碍性贫血常用的治疗选择;然而,它们会带来相当多的不良反应,包括肾毒性。本病例报告描述了一名74岁的纯红细胞再生障碍性贫血患者,其在接受环孢素治疗后出现了长期肾损伤。肾性贫血是慢性肾损伤后的常见并发症,也是贫血治疗效果不佳的原因之一。经过一系列药物调整,最终使用罗沙司他联合西罗莫司进行治疗,被证明可有效延缓该患者肾功能的损害,血红蛋白水平始终保持在100g/L以上。本病例报告证明了罗沙司他联合免疫抑制剂治疗纯红细胞再生障碍性贫血合并肾损伤的疗效,具有缓解贫血和降低血清肌酐水平的双重作用。

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