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OKT3の投与に関連したノソコミアル無菌性髄膜炎
M A Martin1, R M Massanari, D D Nghiem
1Department of Medicine, University of Iowa College of Medicine, Iowa City.
JAMA
|April 1, 1988
まとめ
アセプティック性髄膜炎は,急性アロインプラント拒絶のために,ネズミのモノクローナル抗体OKT3 (muromonab-CD3) で治療された腎臓移植患者で発生しました. この状態は,OKT3投与と強く関連しており,自己限定的な状態であるように見えた.
科学分野:
- ネフロロジーは腎臓科
- 免疫学 免疫学とは
- 感染症 感染症は感染症です.
背景:
- ノソコミアル無菌性髄膜炎は,免疫力が低下した患者のまれな合併症です.
- ネズミのモノクローナル抗体OKT3 (muromonab-CD3) は,急性腎臓アロ移植拒絶症の治療に使用されています.
- 腎臓移植を受けた患者で髄膜炎の発生が観察されました.
研究 の 目的:
- 腎臓アロインプラント受容者における無菌性髄膜炎の発生を調査する.
- 移植患者の髄膜炎の潜在的な危険因子を特定する.
- OKT3療法と無菌性髄膜炎との関連を判断する.
主な方法:
- 経後的なケース・コントロール研究で,髄膜炎と髄膜炎のない患者を比較した.
- 脳脊髄液の培養は,感染症の原因を排除するために行われました.
- OKT3を投与された患者の髄膜炎の将来的な監視が実施されました.
主要な成果:
- OKT3投与後72時間以内に4人の腎臓アロインプラント受容者が無菌性髄膜炎を発症した.
- 脳脊髄液から感染症剤は分離されなかった.
- アセプティック髄膜炎は,OKT3治療と強く関連していました.
- プロスペクティブ・サーベイランスは,OKT3.3で治療された21人の患者の3例 (14%) の無菌性髄膜炎を特定した.
結論:
- OKT3の投与は,腎臓移植を受けた患者の無菌性髄膜炎の発症と強く関連しています.
- OKT3に関連した無菌性髄膜炎の臨床経過は良性であり,自己限定的であるようです.
- 髄膜炎に対するOKT3治療の継続的なモニタリングは正当である.
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