在患有活跃牛皮关节炎的患者中,在ixekizumab治疗期间发生了脑因性炎症性损伤
Antonio Marangi1, Francesco Benvenuti2, Linda Mazzai3
1Department of Neurosciences, Neurology Unit, San Bortolo Hospital, Vicenza, Italy.
The neurologist
|January 22, 2024
概括
一个罕见的脑炎症病变发生在一个患者治疗伊克齐祖马布 (抗干素-17A疗法) 为牛皮关节炎. 该病变通过类固醇治疗得到解决,这凸显了接受这些先进生物药物的患者需要保持警的必要性.
科学领域:
- 神经免疫学 神经免疫学
- 皮肤病学 皮肤病学
- 类风湿病学 类风湿病学
背景情况:
- 伊克西祖马布是一种抗素-17A (IL-17A) 抗体,用于治疗斑块性牛皮,牛皮关节炎和性脊柱炎.
- 中枢神经系统 (CNS) 炎症事件在IL-17A抑制剂中不常见;以前只报告了一例髓炎病例.
研究的目的:
- 报告与ixekizumab治疗相关的大脑炎症病变的第一例.
- 为了强调在IL-17A抑制过程中可能出现罕见的神经并发症.
主要方法:
- 一名患有牛皮关节炎的72岁男性在ixekizumab开始后出现了急性面部麻木.
- 大脑MRI揭示了一个涉及头骨神经V和VII的脑下腔损伤.
- 通过神经导航指导的大脑活检发现了泡状囊细胞;感染和恶性瘤被排除在外.
- 德甲治疗导致临床改善,并在随访核磁共振扫描时导致病变的消失.
主要成果:
- 组织学分析证实了由泡性囊细胞组成的脑炎性病变.
- 在接受皮质类固醇治疗后,病变几乎完全消失.
- 没有发现瘤,感染或初级细胞瘤的证据.
结论:
- 这是ixekizumab治疗期间脑炎症病变的首例记录.
- 神经学不良事件虽然很少发生,但在抗IL-17A治疗期间可能会出现.
- 对接受IL-17A抑制剂治疗的患者进行警监测,对于早期检测潜在的神经并发症至关重要.
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