与乳腺恶性瘤并发的抗SRP阳性死肌病
Tarini Dandasena1, Vaibhav Ingle2, Abhishek Singhai3
1Department of General Medicine, All India Institute of Medical Science-Bhopal, Bhopal, India.
BMJ case reports
|December 11, 2023
概括
抗信号识别粒子 (anti-SRP) 阳性化肌病是一种严重的疾病,通常对标准治疗有抗性. 利图西马布在耐火抗SRP阳性免疫媒介性缩肌病症患者中显示出显著的恢复,即使与恶性瘤相关.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
背景情况:
- 抗信号识别颗粒 (anti-SRP) 阳性死肌病症呈现为严重的渐进性肌肉衰弱,影响吞,言语和呼吸.
- 传统的治疗方法,如高剂量类固醇和其他免疫抑制剂,往往是无效的,将这种情况归类为耐火性肌肉炎.
- 抗SRP自身抗体在少量异形性炎性肌肉病例中被发现,但耐火性形式的患病率尚未确立.
研究的目的:
- 在患有多种并发症的患者中报告一种抗SRP阳性的免疫媒介性死肌病 (IMNM) 病例.
- 评估Rituximab作为第二线治疗在抗SRP阳性的耐火IMNM病例中的疗效.
- 要突出与恶性瘤相关的抗SRP阳性IMNM的罕见关联.
主要方法:
- 一位患有亚急性抗SRP阳性的IMNM患者的病例报告.
- 对类固醇,甲醇和静脉注射免疫球蛋白 (IVIG) 的治疗反应的审查.
- 评估Rituximab治疗后患者的康复情况以及随后的乳腺恶性瘤诊断.
主要成果:
- 患者对初始疗法反应不佳,包括类固醇,甲醇和IVIG.
- 在治疗Rituximab后,观察到显著的临床改善和恢复.
- 随后,该患者被诊断出患有乳腺恶性瘤,这表明罕见的恶性瘤相关抗SRP阳性IMNM病例.
结论:
- 利图西马布可以成为耐火抗SRP阳性IMNM的有效治疗选择,即使在患有并发症的患者中也是如此.
- 抗SRP阳性IMNM与恶性瘤之间的关联,虽然很少见,但在患者管理中需要考虑.
- 需要进一步的研究,以了解耐火抗SRP阳性IMNM的流行率和最佳治疗策略,特别是与癌症相关的IMNM.
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