利妥昔单抗致华氏巨球蛋白血症患者乙型肝炎病毒再激活一例  

Hepatitis B virus reactivation caused by long-term administration of rituximab in a patient with waldenstrom macroglobulinemia:a case report

作　　者：付敬敬 王钱 蔡少平 张海燕[2] 范振平 FU Jingjing;WANG Qian;CAI Shaoping;ZHANG Haiyan;FAN Zhenping(Department of the Fifth Cadre Health Care,the Fifth Medical Center of the Chinese PLA General Hospital,Beijing 100039,China;Department of the Fifth Cadre Health Care,the Second Medical Center of the Chinese PLA General Hospital,National Clinical Research Center for Geriatric Diseases,Beijing 100853,China)

机构地区：[1]解放军总医院第五医学中心保健五科,北京100039 [2]解放军总医院第二医学中心保健五科国家老年疾病临床研究中心,北京100853

出　　处：《临床药物治疗杂志》2024年第6期87-89,共3页Clinical Medication Journal

摘　　要：本文报道1例患有华氏巨球蛋白血症、单纯HBsAb阳性的96岁男性患者,长期规律静脉滴注利妥昔单抗,在随访过程中发现HBsAg血清学逆转、HBV-DNA转阳和肝功能异常。经医师全面排查,考虑为利妥昔单抗引起的HBV再激活,暂停静脉滴注利妥昔单抗,给予口服恩替卡韦抗病毒治疗、五酯胶囊保肝降酶治疗后病情稳定,避免了严重不良事件的发生。通过对本病例的分析,以期为利妥昔单抗的临床治疗提供参考。This article reports a 96-year-old male patient with Waldenstrom macroglobulinemia and positive HBsAb only.The patient,who was on a regular intravenous rituximab regimen,showed serological reversal of HBsAg,HBV-DNA positivity,and abnormal liver function during follow-up.After comprehensive screen,physician judged it as the reactivation of hepatitis B virus caused by rituximab.Rituximab was discontinued,and the patient was treated with oral entecavir for antiviral therapy and wuzhi capsules for hepatoprotection and enzyme reduction.The patient's condition was stable and serious adverse events were avoided.The analysis of this case aims to provide a reference for rational use of rituximab.

关 键 词：利妥昔单抗 乙型肝炎病毒 乙型肝炎病毒表面抗体 华氏巨球蛋白血症 乙型肝炎病毒再激活 

分 类 号：R979.1[医药卫生—药品] R733[医药卫生—药学]