[阿仑单抗诱发的Graves病]。

Q4 Medicine Problemy endokrinologii Pub Date : 2023-06-30 DOI:10.14341/probl13238
M S Sheremeta, M O Korchagina, R M Guseinova, T E Schmidt, K S Nizhegorodova, N Yu Sviridenko, G A Melnichenko
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摘要

多发性硬化症(MS)是一种严重的中枢神经系统慢性自身免疫性脱髓鞘疾病,由Th1/Th17淋巴细胞以及B淋巴细胞、巨噬细胞等免疫细胞介导。一些MS患者接受阿仑妥珠单抗治疗,阿仑妥珠单抗是一种针对CD52+细胞的单克隆抗体,属于疾病修饰疗法(DMTs)。阿仑单抗的主要作用与免疫募集的改变有关。阿仑单抗治疗可以诱导免疫再平衡背景下的继发性自身免疫。甲状腺通常参与自身免疫过程。格雷夫斯病(GD)最常发生,其次是自身免疫性甲状腺炎。我们报告了一例阿仑单抗治疗多发性硬化症后发生GD的患者,由于抗甲状腺药物治疗GD后甲状腺毒症复发,该患者被转介到内分泌研究中心放射性核素治疗科放射碘治疗(RAIT)。2个月达到治疗目的,开始甲状腺激素治疗,在此背景下,甲状腺功能有代偿。
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[Alemtuzumab-induced Graves' disease].

Multiple sclerosis (MS) is a severe chronic autoimmune demyelinating disease of the central nervous system, mediated by Th1/Th17 lymphocytes as well as B lymphocytes, macrophages and other immune cells. Some patients with MS are treated with alemtuzumab, a monoclonal antibody against CD52+ cells, which belongs to the disease-modifying therapies (DMTs). The main effect of alemtuzumab is related to changes in immune recruitment. Alemtuzumab therapy can induce secondary autoimmunity against the background of immune rebalancing. The thyroid gland is generally involved in the autoimmune process. Graves' disease (GD) develops most often, followed by autoimmune thyroiditis.We present a clinical case of a patient with GD developed after alemtuzumab therapy for MS. The patient was referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Centre for radioiodine therapy (RAIT) due to relapse of thyrotoxicosis after anti-thyroid drug therapy for GD. The goal of treatment was achieved in 2 months, thyroid hormone therapy was initiated, against the background of this, there was compensation of thyroid function.

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来源期刊
Problemy endokrinologii
Problemy endokrinologii Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
1.40
自引率
0.00%
发文量
59
期刊介绍: Since 1955 the “Problems of Endocrinology” (or “Problemy Endocrinologii”) Journal publishes timely articles, balancing both clinical and experimental research, case reports, reviews and lectures on pressing problems of endocrinology. The Journal is aimed to the most topical issues of endocrinology: to chemical structure, biosynthesis and metabolism of hormones, the mechanism of their action at cellular and molecular level; pathogenesis and to clinic of the endocrine diseases, new methods of their diagnostics and treatment. The Journal: features original national and foreign research articles, reflecting world endocrinology development; issues thematic editions on specific areas; publishes chronicle of major international congress sessions and workshops on endocrinology, as well as state-of-the-art guidelines; is intended for scientists, endocrinologists diabetologists and specialists of allied trade, general practitioners, family physicians and pediatrics.
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