在初级渐进性多发性硬化症中首次报告了与ocrelizumab相关的白细胞结晶性血管炎病例:一个病例报告
Mohammadali Nahayati1, Mina Farahnezhad2, Amir Khanmirzaei3
1Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Case reports in neurology
|December 1, 2025
概括
白细胞结晶性血管炎 (LCV) 是ocrelizumab的罕见副作用,这是一种治疗初级渐进性多发性硬化症 (PPMS) 的药物. 本案例研究详细介绍了一名患者在开始使用ocrelizumab后发展出LCV,强调需要监测.
科学领域:
- 神经学 神经学
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 白细胞囊性血管炎 (LCV) 是一种小血管血管炎,通常影响皮肤.
- LCV与特定药物之间的关联没有得到广泛的记录.
- 奥克雷利祖马布是一种用于治疗初级渐进性多发性硬化症 (PPMS) 的单克隆抗体.
研究的目的:
- 报告第一例与治疗PPMS的ocrelizumab相关的LCV病例.
- 突出治疗ocrelizumab的患者中药物诱导血管炎的可能性.
- 为了提高人们对ocrelizumab副作用的认识.
主要方法:
- 一个49岁的女性患有PPMS的病例研究.
- 临床表现下肢胀和可触摸的紫外线后ocrelizumab启动.
- 皮肤活检确认LCV,包括血管壁破坏和中性粒细胞透.
- 炎症标志物 (ESR,CRP) 的实验室评估.
主要成果:
- 患者在开始服用ocrelizumab后一周就出现了LCV.
- 皮肤活检证实了LCV与特征性组织病理学发现.
- 观察到炎症标志物 (ESR: 52,CRP: 52.8) 的升高.
- 症状通过静脉注射甲基prednisolone解决,和ocrelizumab安全地恢复.
结论:
- 这是第一次报告与PPMS治疗中的ocrelizumab相关的LCV病例.
- 在接受ocrelizumab治疗的患者中,临床医生应对药物诱导的血管炎保持警.
- 这一案例扩大了对ocrelizumab潜在不良事件的理解.
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