夏普综合症:从基本的抗炎治疗到基因工程生物药物

K. Shaporeva, S. Lapshina, E. Sukhorukova, A. Garaeva, R. Abdrakipov, D. Abdulganieva
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引用次数: 0

摘要

本文提出一个混合性结缔组织病的临床病例。临床表现多态,患者有关节炎、皮损、全身性炎症、肌病、雷诺综合征、吞咽困难、血管神经性水肿。免疫组反映了自身免疫性疾病特有的抗体的存在(抗核抗体、核糖核蛋白抗体、抗线粒体抗体、细胞质抗原SS-B抗体)。开始使用糖皮质激素(GCS),免疫抑制药物(metatrexate, sulfasalazine, hydroxychloroquine, azathiopine),但疾病进展。GCS脉冲治疗和血浆置换均未见阳性结果。我们使用利妥昔单抗,因为该疾病的发病机制以b细胞活化为特征。目前,已经进行了两次输注,已注意到积极的动态。因此,混合性结缔组织病的治疗在临床实践中产生了许多诊断和治疗问题。
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Sharpe’s syndrome: from basic anti-inflammatory therapy to genetically engineered biological drugs
This article presents a clinical case of a patient with a mixed connective tissue disease. The clinical picture in the debut was polymorphic, the patient had arthritis, skin lesions, general inflammation, myopathy, Raynaud’s syndrome, dysphagia, angio-neurotic edema. The immunological panel reflected the presence of antibodies characteristic of autoimmune diseases (antinuclear antibodies, antibodies to ribonucleoprotein, antimitochondrial antibodies, antibodies to cytoplasmic antigen SS-B). Glucocorticosteroids (GCS), immunosuppressive drugs (metatrexate, sulfasalazine, hydroxychloroquine, azathioprine) were used as starting therapy, but the disease progressed. Pulse therapy of GCS and plasmapheresis did not give a positive result. We used Rituximab, because the pathogenesis of the disease was characterized by the activation of B-cells. Currently, two infusions have been performed, positive dynamics has been noted. Thus, the therapy of mixed connective tissue disease creates many diagnostic and therapeutic problems in clinical practice.
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