Refractory pemphigus foliaceus and Beh‡et's disease successfully treated with tocilizumab
Refractory pemphigus foliaceus and Beh‡et's disease successfully treated with tocilizumab
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DOI：
10.1007/s12026-013-8411-1
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发表时间：
2013-07-01
影响因子：
4.4
通讯作者：
Doria, Andrea
中科院分区：
文献类型：
--
作者：
Caso, Francesco;Iaccarino, Luca;Doria, Andrea
叶状天疱疮(Pf)和Beh双匕首病(BD)是一种免疫介导性疾病，通常使用皮质类固醇、免疫抑制剂治疗，如果治疗无效，则使用生物制剂。在这两种疾病中，血清白介素6水平升高，推动了免疫介导的炎症过程。Tocilizumab是一种针对IL6受体的人源化单抗，用于治疗类风湿性关节炎。除了目前的适应症，它最近还被用于难治性免疫性炎症性疾病患者的非标签治疗。在这里，我们报告了一例感染了PF和BD的妇女，她对皮质类固醇、免疫抑制剂和生物制剂包括阿达利单抗、阿那金纳和英夫利昔单抗没有反应。只有使用tocilizumab才能获得完全、持久的临床和血清学缓解。据我们所知，PF和BD之间的联系从未被报道过。此外，到目前为止，只有两例BD和没有使用tocilizumab治疗的PF病例被描述。并对生物制剂在PF和BD患者中的应用进行了文献复习。
Pemphigus foliaceus (PF) and Beh double dagger et's disease (BD) are immune-mediated conditions which are usually treated with corticosteroids, immunosuppressants, and, when refractory, with biologic agents. In both diseases, interleukin (IL)-6 serum levels are increased driving the immune-mediated inflammatory process. Tocilizumab is a humanized monoclonal antibody, targeting IL6-receptor, used in the treatment of rheumatoid arthritis. Besides the current indication, it has been recently administered to patients with refractory immune inflammatory diseases as an off-label treatment. Here, we report the case of a woman affected with PF and BD, who did not respond to corticosteroids, immunosuppressants, and biologic agents including adalimumab, anakinra, and infliximab. A complete, long-lasting, clinical, and serological remission was achieved only with tocilizumab. To the best of our knowledge, the association between PF and BD has never been reported. Moreover, only two cases of BD and no cases of PF treated with tocilizumab have been described to date. A literature review on the use of biologic agents on patients with PF and BD was also carried out.