用Etanercept治疗的类风湿性关节炎患者的意外多发性硬化症类症状:一个病例报告
Ali Hosseinpour1,2, Arsh Haj Mohamad Ebrahim Ketabforoush3, Elnaz Daneshzad2
1Clinical Research Development Unit (CRDU) of Shahid Rajaei Hospital Alborz University of Medical Sciences Karaj Iran.
Clinical case reports
|October 29, 2024
概括
像Etanercept这样的瘤坏死因子 (TNF) 抑制剂很少会在类风湿性关节炎患者中引发类似于多发性硬化症 (MS) 的症状. 用皮质类固醇及B细胞枯竭疗法的及时治疗导致了快速的临床改善.
科学领域:
- 神经免疫学 神经免疫学
- 类风湿病学 类风湿病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 瘤坏死因子 (TNF) 抑制剂广泛用于诸如类风湿性关节炎 (RA) 等自身免疫性疾病.
- 作为TNF抑制剂的Etanercept很少会导致中枢和外围神经系统的脱髓化.
- 与TNF抑制剂相关的脱髓化确切原因仍在争论中.
研究的目的:
- 在接受ETANERCEPT治疗RA的患者中报告多发性硬化症 (MS) 类似综合征的病例.
- 突出TNF抑制剂对中枢神经系统的潜在不良影响.
主要方法:
- 一个35岁妇女的病例报告与RA治疗Etanercept.
- 临床表现包括麻醉,帕帕雷西斯和尿.
- 治疗包括停止使用Etanercept,并开始使用甲基前尼索隆和利图西马布.
主要成果:
- 患者在开始服用Etanercept后大约一年出现了MS类症状.
- 在停止治疗和开始使用甲基普雷迪尼索隆和利图西马布后,观察到快速的临床改善.
- 在6个月的随访期间,没有注意到神经系统的恶化.
结论:
- 开始服用乙素可能会在易受感染的个体中引发MS类综合征.
- 医疗保健提供者应对接受TNF抑制剂的患者的神经学不良影响保持警.
- 早期识别和适当的管理对于有利的结果至关重要.
相关概念视频
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
7
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
7
T Cell Types and Functions
955
When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
955
Rheumatic Heart Disease I: Introduction
3
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
3
Rheumatic Heart Disease IV: Nursing Management
5
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
5
Autoimmune Disorders
390
Autoimmune diseases are a group of disorders in which the body's immune system mistakenly attacks its own cells, tissues, and organs. This results from an overactive immune response against substances and tissues normally present in the body. Let's delve into the concept and mechanism of autoimmune diseases from an immune system point of view, explore different causes and examples of such diseases, and discuss potential solutions.
Concept and Mechanism of Autoimmune Diseases
The immune...
Concept and Mechanism of Autoimmune Diseases
The immune...
390
The JAK-STAT Signaling Pathway
8.7K
Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as SH2...
8.7K


