在炎症性肠病中TNF抑制剂诱导的类病变
Zlata Chkolnaia1, Benedicte Lebrun-Vignes2, Aurelien Amiot3
1Paris Cite University, Paris, France.
United European gastroenterology journal
|December 8, 2025
概括
瘤坏死因子 (TNF) 抑制剂在炎症性肠道疾病患者中很少会导致类似沙尔科毒症的疾病. 停止TNF抑制剂和类固醇治疗有效地管理这些矛盾反应.
科学领域:
- 胃肠道学和免疫学
- 肺部病理学 肺部病理学
- 药物监督 药物监督 药物监督
背景情况:
- 已知瘤亡因子 (TNF) 抑制剂的悖论性反应,但类似肉类病的疾病很少见.
- 这项研究侧重于TNF抑制剂诱导的炎症性肠病 (IBD) 患者的沙尔科毒症的特征.
研究的目的:
- 在IBD患者中描述由TNF抑制剂诱导的类病变的流行病学,诊断和治疗特征.
- 为了提高人们对这种罕见的药物不良反应的认识.
主要方法:
- 在59个机构进行了一系列案例调查.
- 诊断需要典型的临床/放射学症状,非死性颗粒瘤组织学,排除其他原因,以及与TNF抑制剂使用的时间联系.
- 一位药监专家证实了药物因果关系.
主要成果:
- 鉴定出14例类型为类型的病变 (9例克罗恩病,4例性结肠炎,1例未分类的IBD).
- 最常见的罪祸首是infliximab和adalimumab,通常是第一次使用生物治疗的用户.
- 常见的症状包括呼吸不全,咳和发烧;停止TNF抑制剂和口服类固醇导致大多数患者的症状消失.
结论:
- 在排除感染后,在患有慢性呼吸道症状或发烧的IBD患者中,应怀疑TNF抑制剂诱导的肉类症.
- 治疗包括停止TNF抑制剂,并开始服用口服类固醇.
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