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静脉注射免疫球蛋白(IVIG)和度普利尤单抗成功治疗Netherton综合征:一例报告

Successful management of Netherton syndrome using IVIG and dupilumab: A case report.

作者信息

Johar Reshale, Khojah Amer, Goronfolah Loie

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

Pediatrics Department, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.

出版信息

J Allergy Clin Immunol Glob. 2025 Jun 2;4(3):100508. doi: 10.1016/j.jacig.2025.100508. eCollection 2025 Aug.

Abstract

Netherton syndrome (NS) is a rare autosomal recessive genodermatosis caused by pathogenic mutations in the serine protease inhibitor Kazal-type 5 () gene, leading to impaired skin barrier function and immune dysregulation. It is characterized by congenital ichthyosis, trichorrhexis invaginata, and severe atopy. Herein, we present the case of a young boy with NS, confirmed by genetic analysis revealing a homozygous splice site mutation in (c.1302+5G>C). The patient was treated with intravenous immunoglobulin due to frequent infections that required multiple hospital admissions. When he was 6 years old, dupilumab was added to reduce skin inflammation and improve skin barrier function before food reintroduction. He demonstrated substantial clinical benefits, with marked relief from pruritus resulting in better quality of life. Additionally, he exhibited notable hair growth. Serologically, total his serum IgE levels decreased from 1078 IU/mL to 55.8 IU/mL following dupilumab therapy. This case highlights the potential benefits of an integrated therapeutic approach in management of this challenging condition.

摘要

Netherton综合征(NS)是一种罕见的常染色体隐性遗传性皮肤病,由丝氨酸蛋白酶抑制剂Kazal型5()基因的致病性突变引起,导致皮肤屏障功能受损和免疫失调。其特征为先天性鱼鳞病、套叠性脆发症和严重特应性。在此,我们报告一例患有NS的小男孩病例,基因分析证实其(c.1302 + 5G>C)存在纯合剪接位点突变。由于频繁感染需要多次住院,该患者接受了静脉注射免疫球蛋白治疗。在他6岁时,在重新引入食物之前,添加了度普利尤单抗以减轻皮肤炎症并改善皮肤屏障功能。他展现出显著的临床益处,瘙痒明显缓解,生活质量得到改善。此外,他的头发生长显著。血清学方面,度普利尤单抗治疗后,他的血清总IgE水平从1078 IU/mL降至55.8 IU/mL。该病例突出了综合治疗方法在管理这种具有挑战性疾病中的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2878/12221484/c1fafd235708/gr1.jpg

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本文引用的文献

2
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