在复发性复发性多发性硬化症中输注ocrelizumab后心脏性休克
Giulia De Napoli1, Enrico Gotti2, Chiara Baldovini3
1Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.
Multiple sclerosis (Houndmills, Basingstoke, England)
|December 31, 2025
概括
一名患有多发性硬化症的患者在接受了ocrelizumab治疗后出现了严重的心脏功能障碍. 这种罕见的副作用是可逆的,强调需要在治疗ocrelizumab期间对心脏进行监测.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 多发性硬化症 (MS) 是一种慢性自身免疫性疾病,影响中枢神经系统.
- 奥克雷利祖马布是一种针对多发性硬化症的向疗法,但其潜在的心脏影响尚未得到充分证实.
- 在服用ocrelizumab后发生的心脏并发症很少见,但需要进行调查.
研究的目的:
- 报告一种罕见的严重心脏功能障碍病例,该病例发生在接受ocrelizumab治疗的患者身上.
- 为了研究与多发性硬化症的ocrelizumab治疗相关的潜在心脏毒性.
- 要强调心脏监测在接受ocrelizumab的患者的重要性.
主要方法:
- 一个42岁的男性患有复发性缓解性多发性硬化症的病例报告.
- 详细的心脏评估,包括血液检查,冠状动脉血管学,心脏核磁共振成像和内心肌活检.
- 排除常见的心脏病因,如缺血或传染病因.
主要成果:
- 患者在ocrelizumab输注后24-36小时内出现了严重的左心室缩功能障碍.
- 症状在10天内进展,但完全可逆.
- 诊断工作排除了心肌梗塞,心肌炎和心脏功能障碍的其他常见原因.
结论:
- 在患有多发性硬化症的患者中,ocrelizumab可能很少引起严重的可逆心脏功能障碍.
- 在接受ocrelizumab治疗的多发性硬化症患者中,对心脏毒性保持警至关重要.
- 需要进一步的研究来了解与ocrelizumab相关的心脏毒性的机制和发病率.
相关概念视频
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
422
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
422
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
570
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
570
01:24Blood Pressure Imbalances and Circulatory Shock
1.4K
Disorders affecting blood volume, vascular tone, or vascular function can disrupt vascular homeostasis, including conditions like hypertension, hemorrhage, and shock.
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
1.4K
01:22Myocarditis IV: Nursing Management
191
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
191
01:14Myocarditis III: Medical Management
155
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
155
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
360
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
360