在患有多种先前存在的自身免疫性疾病的患者中,阿达利穆马布诱导的中枢神经系统脱髓化:考虑治疗
Sepehr Khosravi1,2, Babak Zamani1, Mohammad Reza Motamed1
1Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Modern rheumatology case reports
|November 7, 2024
概括
瘤坏死因子 (TNF) 抑制剂,如阿达利木马布,可以在易受感染的个体中引发脱髓化疾病,如多发性硬化症. 早期诊断和疾病修饰性治疗对于控制这种不良影响至关重要.
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:
- 抗瘤坏死因子 (TNF) 药物对类风湿性疾病有效.
- 这些药物与脱髓化疾病有关,包括多发性硬化症.
- 了解这种关联对于患者安全至关重要.
研究的目的:
- 报告可能由阿达利姆巴诱导的多发性硬化症 (MS) 病例.
- 讨论在接受抗TNF治疗的患者中MS的管理.
- 要突出自身免疫和治疗点之间的复杂关系.
主要方法:
- 一个47岁的妇女患有类风湿性关节炎和中间级紫外炎的病例报告.
- 临床评估,脑磁共振成像 (MRI) 在抗TNF治疗前后.
- 停用阿达利穆马布,使用静脉葡萄糖皮质类药物和利图西马布治疗.
主要成果:
- 患者在接受了2年的阿达利木巴治疗后,患上了多发性硬化症,具有特征性的MRI病变.
- 停用了阿达利马布,患者用葡萄糖皮质类药物和修复药得到改善.
- 在1年后的随访MRI中没有观察到新的病变.
结论:
- 抗TNF治疗可能会在易受影响的个体中加速脱髓化疾病.
- 停止使用抗TNF药物可能需要额外的疾病修饰治疗.
- 遗传倾向和彻底的病史对于自身免疫性疾病的个性化医学至关重要.
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