[与IgG4相关疾病结合的类风湿性关节炎成功用Rituximab治疗:一个病例报告]
Yan Ding1, Lifang Wang1, Chaoran Li1
1Department of Rheumatology and Immunology, Peking University Shougang Hospital, Beijing 100144, China.
概括
类风湿性关节炎带有升高的乙氨基细胞可能表明与IgG4相关的并发性疾病. 利图西马布治疗有效地控制了关节症状,并降低了氨基酸水平,在复杂的病例中实现了缓解.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,导致关节炎症.
- 在RA患者中,乙氨基的升高可以表明不同的临床特征和潜在的并发症.
- 免疫球蛋白G4相关疾病 (IgG4-RD) 是一种可以影响多个器官的纤维炎症性疾病.
研究的目的:
- 报告一种与IgG4相关疾病复杂的类风湿性关节炎病例.
- 讨论RA患者的诊断和治疗策略.
- 为了突出利图西马布在管理这些复杂病例中的潜在作用.
主要方法:
- 一个患有多关节胀和疼痛的患者的临床表现分析.
- 实验室检测包括类风湿因子,抗素抗体,抗循环素抗体,抗核核因子,红细胞沉积率和血清IgG4水平.
- 影像研究 (淋巴结和腺超声波) 和活检 (骨髓,淋巴结).
主要成果:
- 这名患者被诊断患有类风湿性关节炎,并增加了外周血液中乙氨基酸细胞.
- 最初的治疗显示出有限的疗效,而随后的甲铁和托西利祖马布治疗改善了关节症状,但没有改善eosinophilia.
- 淋巴腺病变和腺扩大的发展导致了IgG4阳性细胞透和血清IgG4升高的识别,证实了并发IgG4-RD.
- 利图西马布治疗导致关节症状显著改善,降低了C-反应蛋白和乙氨基基基水平,实现了疾病缓解.
结论:
- 肌痛性关节炎患者具有升高的乙氨基基细胞需要警潜在的并发性IgG4-RD.
- 利图西马布为管理因IgG4-RD和eosinophilia而复杂的RA提供了一个有前途的治疗选择.
- 早期识别和综合治疗策略对于最佳的患者结果至关重要.
相关概念视频
01:23Rheumatic Heart Disease I: Introduction
407
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...
407
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
443
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...
443
01:21Rheumatic Heart Disease III: Medical Management
264
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
264
01:11Genome-wide Association Studies-GWAS
15.2K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
15.2K
01:20Rheumatic Heart Disease IV: Nursing Management
247
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...
247
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
445
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
445