超小剂量利妥昔单抗治疗ANCA相关性血管炎一例  

ANCA Associated Vasculitis Treated with Ultra⁃low Dose Rituximab:A Case Report

作　　者：吴海婷[1] 李航[1] WU Haiting;LI Hang(Department of Nephrology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院肾内科,北京100730

出　　处：《协和医学杂志》2023年第6期1330-1334,共5页Medical Journal of Peking Union Medical College Hospital

基　　金：中央高水平医院临床科研专项(2022-PUMCH-A-170)。

摘　　要：本文报道一例肺、肾受累的抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibodies, ANCA)相关性血管炎患者,给予经典的糖皮质激素、环磷酰胺、血浆置换诱导缓解治疗有效。该患者在使用硫唑嘌呤维持治疗期间共出现2次感染,后换用超小剂量(100 mg/次)利妥昔单抗维持治疗病情稳定。个体化利妥昔单抗治疗ANCA相关性血管炎效果显著,同时避免了过度免疫抑制,减轻了患者的经济负担。本例患者的诊疗经验有助于提高临床医生在ANCA相关性血管炎维持治疗方面的认识。We reported a case of ANCA-associated vasculitis with pulmonary and renal involvement that was effectively treated with glucocorticoids,cyclophosphamide,and plasma exchange therapy.The patient suf-fered two infections during maintenance treatment with azathioprine and was later switched to ultralow-dose(100 mg)rituximab to keep the disease in remission.Individualized rituximab therapy is effective in treating ANCA-associated vasculitis,while avoiding excessive immunosuppression,and reducing the financial burden.The diagnosis and treatment of this patient may help clinicians improve their understanding of maintenance ther-apy for ANCA-associated vasculitis.

关 键 词：抗中性粒细胞胞浆抗体相关性血管炎 利妥昔单抗 硫唑嘌呤 

分 类 号：R692.3[医药卫生—泌尿科学] R543[医药卫生—外科学]