利格列汀相关的BP230型大疱性类天疱疮一例国内首报  

Anti-BP230-type bullous pemphigoid associated with linagliptin treatment:first case report in China

作　　者：万立 刘美娜 陈金波[2] 陈柳青[2] Wan Li;Liu Meina;Chen Jinbo;Chen Liuqing(School of Medicine,Jianghan University,Wuhan 430056,China;Department of Dermatology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]江汉大学医学院,武汉430056 [2]武汉市第一医院皮肤科,430022

出　　处：《中华皮肤科杂志》2021年第2期136-138,共3页Chinese Journal of Dermatology

基　　金：国家自然科学基金(81101190);米尔斯坦亚美医学基金会皮肤病研究项目基金(MMAAP,2018年);江汉大学科研创新基金项目(YKYCXJJYX18001)。

摘　　要：患者女,66岁,因头皮、颈部水疱1个月就诊。既往有2型糖尿病病史6年,于起疹前6个月开始口服二肽基肽酶4抑制剂利格列汀5 mg每日1次。皮肤科检查:头皮散在绿豆至花生米大小水疱,部分水疱破溃,可见渗出、结痂;左侧颈部一鸽蛋大小大疱及2个绿豆大小水疱,疱壁紧张,疱液清亮,基底无明显红斑,尼氏征阴性。酶联免疫吸附试验示抗BP180 NC16A抗体5.81 kU/L、抗BP230抗体139.76 kU/L。颈部皮损组织病理检查示表皮下水疱形成,疱内中性粒细胞及少许嗜酸性粒细胞浸润。诊断:BP230型局限型大疱性类天疱疮。该例二肽基肽酶4抑制剂相关的BP230型大疱性类天疱疮为国内首次报道。A 66-year-old female patient presented with blisters on the scalp and neck for 1 month.She had a history of type 2 diabetes for 6 years,and started taking the dipeptidyl peptidase-4 inhibitor linagliptin at a dose of 5 mg once a day 6 months before the onset of eruption.Skin examination showed scattered mung bean-to peanut-sized blisters on the scalp,and some blisters broke with exudation and crusts.There was a pigeon egg-sized bulla and two mung bean-sized blisters on the left neck,with tense blister walls,clear blister fluids,non-erythematous base,and Nikolsky′s sign was negative.Enzyme-linked immunosorbent assay revealed that the serum levels of anti-BP180 NC16A and anti-BP230 antibodies were 5.81 and 139.76 kU/L respectively.Histopathological examination of the blister on the neck showed subepidermal blister formation,and infiltration with neutrophils and a few eosinophils in the blister.The patient was finally diagnosed with localized anti-BP230-type bullous pemphigoid.This case of anti-BP230-type bullous pemphigoid associated with the dipeptidyl peptidase-4 inhibitor linagliptin was firstly reported in China.

关 键 词：类天疱疮 大疱性 二肽基肽酶Ⅳ抑制剂 抗BP230抗体 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]