贝利尤单抗联合环孢素治疗难治性系统性红斑狼疮继发免疫性血小板减少1例并文献复习  

Literature review on treatment of immune thrombocytopenia secondary to refractory systemic lupus erythematosus with belimumab combined with cyclosporine:A case report and literature review

作　　者：秦梅杰 田茂露[2] 杨宇齐 查艳[2] 袁静[2] Qin Meijie;Tian Maolu;Yang Yuqi;Zha Yan;Yuan Jing(Zunyi Medical University,Zunyi 563003,China;Department of Nephrology,Guizhou Provincial People’s Hospital,Guiyang 550002,China)

机构地区：[1]遵义医科大学,贵州遵义563003 [2]贵州省人民医院肾内科,贵州贵阳550002

出　　处：《临床荟萃》2022年第6期544-547,共4页Clinical Focus

基　　金：贵州省科学技术基金长链非编码RNA Cdat 1通过调控CaMKⅡ/AMPK/NF-kB信号通路影响糖尿病肾病慢性纤维化(黔科合基础[2019]1194号);贵州省卫健委科学技术基金长链非编码RNA Cdat 1在糖尿病肾病中的作用及其机制研究(gzwjkj2019-1-107)。

摘　　要：目的探讨贝利尤单抗治疗难治性系统性红斑狼疮(systemic lupus erythematosus,SLE)合并顽固性血液系统损害的疗效。方法回顾性分析贵州省人民医院收治的1例以顽固性血液系统损害为主要表现的SLE病例的诊治过程。结果患者为青年女性,SLE病史1年余,因皮下瘀斑伴腹痛10天入院,住院后明确诊断SLE合并难治性血液系统损害,在环孢素等基础治疗上加用贝利尤单抗维持治疗后,患者病情明显改善,且未见不良反应。随访1年余,患者激素用量已减至最低维持量,无复发。结论贝利尤单抗联合环孢素治疗为难治性SLE继发免疫性血小板减少的治疗提供了新选择,更多的临床应用证据有待长期的大样本病例研究观察、评估。Objective To explore the effects of belimumab on systemic lupus erythematosus(SLE)complicated with refractory hematological damage.Methods A SLE patient mainly featured with refractory hematological damage admitted to Guizhou Provincial People's Hospital was retrospectively analyzed.Results The female patient with more than 1 year history of SLE was admitted to hospital for sub dermal ecchymosis complicated with abdominal pain lasting 10 days,was clearly diagnosed as SLE with refractory blood system damage after hospitalization.The patient's condition was significantly improved without adverse reactions after maintenance therapy with belimumab in addition to basic treatment including cyclosporine.The patient was followed up for more than 1 year,the glucocorticoid dosage was minimized,and no recurrence of disease was found.Conclusion Combination of belimumab with cyclosporine in the treatment of refractory SLE secondary immune thrombocytopenia provides a new treatment option,and more clinical efficacy remains to be observed and evaluated in the long term.

关 键 词：红斑狼疮 系统性 紫癜 血小板减少性 特发性 抗体 单克隆 

分 类 号：R593.241[医药卫生—内科学]