儿科风湿病学中的阿纳金拉和肝毒性:一个病例系列
Frederico Rajão Martins1, André Costa Azevedo2, Sara Ganhão3
1Rheumatology Department, University Hospital Centre Algarve, Faro, Portugal. jrmartins@chalgarve.min-saude.pt.
Pediatric rheumatology online journal
|October 6, 2023
概括
用于全身性青少年异常性关节炎和其他疾病的阿纳金拉可以在儿童中引起罕见的肝损伤,特别是患有巨细胞激活综合征的儿童. 在治疗儿科类风湿性疾病时,监测肝功能至关重要.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 药物监督 药物监督 药物监督
- 免疫学 免疫学 免疫学
背景情况:
- 亚纳金拉 (重组性互乐金-1受体对抗剂) 治疗全身性青少年异常性关节炎 (sJIA),川崎病 (KD) 和冷氨酸相关自身炎症综合征 (CAPS).
- 虽然很少见,但已经报告了与anakinra相关的肝毒性.
- 本病例系列详细介绍了三名儿科患者在KD和sJIA的二次性巨细胞激活综合征 (MAS) 治疗期间经历了肝毒性.
研究的目的:
- 在患有类风湿性疾病的儿科患者中报告与anakinra相关的肝毒性.
- 在巨细胞激活综合征 (MAS) 的背景下强调肝损伤的发生.
- 为儿童类风湿病学中提供关于anakinra治疗监测的见解.
主要方法:
- 一系列病例描述了三名被诊断为KD和sJIA次要的MAS的儿科患者.
- 患者接受了阿纳金拉 (2毫克/公斤/天) 治疗严重症状.
- 记录了临床表现,实验室值 (包括肝酶和费里),以及治疗结果.
主要成果:
- 三名儿科患者在开始服用阿纳金拉后出现了新发作的恶心和严重的细胞胆固醇形成或肝酶升高.
- 在所有病例中,停用anakinra后肝毒性都消失了.
- 这发生在严重的MAS复杂化KD和sJIA的环境中.
结论:
- 这是第一个描述儿基因拉相关肝毒性的病例系列,该病例描述了儿科患者患有除sJIA之外的类风湿性疾病.
- 这些发现强调了在接受anakinra的儿科患者,特别是那些患有MAS的儿科患者中,警性肝功能监测的重要性.
- 可能需要进一步的研究来阐明这种人群中阿纳金拉诱导的肝损伤的机制和危险因素.
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