在2名患有多发性硬化症的患者中,Ocrelizumab输注后的血清疾病/血清疾病类反应
Nicole Bou Rjeily1, Bardia Nourbakhsh1, Ellen M Mowry1
1From the Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD (NBR, BN, EMM).
International journal of MS care
|September 18, 2023
概括
血清疾病 (SS) 是对像ocrelizumab这样的单克隆抗体的罕见反应,在多发性硬化症 (MS) 患者中可以表现为关节痛. 及时的类固醇治疗可以有效地管理这些症状.
科学领域:
- 临床神经学 临床神经学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 血清疾病 (SS) 是一种罕见的免疫复杂介导过敏反应.
- 单克隆抗体,包括用于多发性硬化症 (MS) 的ocrelizumab,很少会触发SS.
- 之前只记录了一例与ocrelizumab相关的SS病例.
研究的目的:
- 在接受ocrelizumab治疗的患者中报告两例新的血清类似疾病反应 (SSLR).
- 要突出临床表现和SSLRs后ocrelizumab的诊断考虑.
- 强调在MS患者中考虑SS/SSLR的重要性,MS患者经历了ocrelizumab输液后的新关节痛.
主要方法:
- 病例报告详细介绍了两名患有原发性进展性多发性硬化症 (MS) 的患者.
- 患者接受了ocrelizumab输液,随后出现了暗示SS/SSLRs的症状.
- 临床评估包括神经学检查,MRI,炎症标志物和传染病检查;监测治疗反应.
主要成果:
- 两名患有初级进展性多发性硬化症的患者 (45岁男性,59岁女性) 在ocrelizumab后出现了全身虚弱和关节痛.
- 神经成像显示没有新的脱髓化病变;炎症标志物升高,并排除了感染原因.
- 两位患者都经历了类固醇逐渐减小的快速和显著的症状改善,证实了假定的SS / SSLRs.
结论:
- 在多发性硬化症患者中,应怀疑血清疾病或类似血清疾病的反应,在ocrelizumab后出现新发性关节痛.
- 对其他疾病的负面反应和对类固醇治疗的快速积极反应支持SS/SSLRs的诊断.
- 这些发现强调需要对MS管理中对ocrelizumab的罕见过敏反应保持警.
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