环磷酰胺与环孢素联用致卡波西肉瘤  

Kaposi′s sarcoma induced by cyclophosphamide combined with ciclosporin

作　　者：唐冯一 孔玮[2] 束庆[3] 葛卫红[3] 彭宇竹 王红[2] Tang Fengyi;Kong Wei;Shu Qing;Ge Weihong;Peng Yuzhu;Wang Hong(Department of Pharmacy,China Pharmaceutical University Nanjing Drum Tower Hospital,Nanjing 210008,China;Department of Rheumatology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Pharmacy,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Nanjing Municipal Health Commission,Nanjing 210008,China)

机构地区：[1]中国药科大学南京鼓楼医院药学部,南京210008 [2]南京大学医学院附属鼓楼医院风湿免疫科,南京210008 [3]南京大学医学院附属鼓楼医院药学部,南京210008 [4]南京市卫生健康委员会,南京210008

出　　处：《药物不良反应杂志》2022年第8期441-443,共3页Adverse Drug Reactions Journal

基　　金：南京市卫生科技发展专项资金—医学重点科技发展项目(ZKX21016)。

摘　　要：1例62岁女性系统性血管炎患者长期应用糖皮质激素和环磷酰胺治疗,因病情控制不佳加用环孢素。应用环孢素4个月余,患者右下肢出现暗红色皮疹,行病变皮肤组织活检,病理和免疫组织化学检查结果提示卡波西肉瘤。患者血淋巴细胞亚群计数未见异常,不支持免疫缺陷性疾病,考虑与免疫抑制药物作用过强有关。将环磷酰胺和环孢素改为雷公藤多苷,糖皮质激素减量,7 d后患者皮疹好转;2个月余后,患者右下肢皮疹消退,皮肤平整、无肿胀。A 62‑year‑old female patient with systemic vasculitis was treated with glucocorticoid and cyclophosphamide for a long time,and then cyclosporine was added due to poor control of the disease.After more than 4 months of cyclosporine treatment,the patient developed a dark red rash on the right lower limb.Later,skin biopsy was performed and pathological examination and immunohistochemical test results suggested Kaposi's sarcoma.No abnormality was found in the blood lymphocyte subsets count of the patient,and the immune deficiency diseases were not considered.Kaposi's sarcoma was considered to be related to the immunosuppressive drugs.Cyclophosphamide and cyclosporine were switched to Leigongteng Duogan(雷公藤多苷)and the dose of glucocorticoid was reduced.Seven days later,the rash in the patient was improved;more than 2 months later,the rash on the patient's right lower limb subsided and the skin was smooth without swelling.

关 键 词：肉瘤 卡波西 免疫抑制剂 环磷酰胺 环孢素 

分 类 号：R969[医药卫生—药理学]