白细胞介素17A单克隆抗体引起水痘性肺炎和肝炎的病例分析及水痘性肝炎特点分析  

Varicella hepatitis and varicella pneumonia caused by interleukin-17A monoclonal antibody:Case report and characteristic analysis

作　　者：陈静[1,2] 李璐[1,2] 李晓光[1,2] 路明[2,3] CHEN Jing;LI Lu;LI Xiao-guang;LU Ming(Department of Infectious Disease,Peking University Third Hospital,Beijing 100191,China;Infectious Disease Center,Peking University Third Hospital,Beijing 100191,China;Department of Respiratory and Critical Care Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院,感染疾病科,北京100191 [2]北京大学第三医院,感染疾病中心,北京100191 [3]北京大学第三医院,呼吸与危重症医学科,北京100191

出　　处：《中国临床药理学杂志》2023年第11期1630-1632,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：本文报道1例使用靶向白细胞介素17A单克隆抗体的银屑病患者感染水痘-带状疱疹病毒后出现水痘性肝炎及水痘性肺炎,并以“水痘、肝炎、免疫抑制”为检索词检索万方数据库和中国期刊全文数据库,以“varicella、varicella hepatitis、immunocompromised”为检索词检索PubMed系统,对检索病例以及本例进行汇总分析。共检索出临床资料相对完整8篇,对上述8例患者和本例共9例进行汇总分析。其中,男6例、女3例,平均年龄30.6岁,2例死亡,其余7例治疗好转后出院;肾移植4例、肝移植1例、艾滋病1例、因哮喘和重症肌无力使用糖皮质激素者各1例;以腹痛为主要症状的患者5例;水痘性肝炎以谷丙转氨酶、谷草转氨酶明显升高为主,肝组织活检病理可以表现为有弥漫性小叶中心肝细胞坏死、脂肪变性,肝细胞再生。除水痘性肝炎外,还可累及多个脏器,呈现播散性水痘感染。免疫抑制宿主水痘感染的临床表现较严重,应加强对免疫抑制宿主水痘感染的重视,改善预后。This article reports a patient with psoriasis who developed varicella hepatitis and varicella pneumonia after being infected with varicella zoster virus using monoclonal antibodies targeting interleukin 17A.The related literatures were reviewed with“varicella,hepatitis/varicella hepatitis,immunosuppressed”as the keywords in CNKI,WanFang and PubMed database.Finally,8 papers were selected for relatively complete clinical data.In the nine immunocompromised cases,there were 6 males and 3 females,mean age was 30.6 years old,and 2 cases died,7 patients were improved after treatment.There were 4 cases of kidney transplantation,1 case of liver transplantation,1 case of acquired immune deficiency syndrome,and 1 case of glucocorticoid for asthma and myasthenia gravis.There were five patients with abdominal pain as the main symptom.In varicella Hepatitis,alanine aminotransferase and aspartate aminotransferase were significantly elevated,and liver biopsy pathology showed diffuse hepatic cell necrosis,steatosis,and hepatic cell regeneration.The clinical manifestations of varicella infection in immunocompromised patients are serious and even fatal.The clinical manifestations of varicella infection in the immunosuppressed hosts are more serious,so more attention should be paid to the immunosuppressed hosts to improve the prognosis.

关 键 词：免疫抑制宿主 水痘性肺炎 水痘性肝炎 白细胞介素17A单克隆抗体 

分 类 号：R97[医药卫生—药品]