Continous Rituximab treatment for recurrent diffuse alveolar hemorrhage in a patient with systemic lupus erythematosus and antiphosholipid syndrome.
Continous Rituximab treatment for recurrent diffuse alveolar hemorrhage in a patient with systemic lupus erythematosus and antiphosholipid syndrome.
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DOI：
10.1016/j.rmcr.2017.09.012
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发表时间：
2017
影响因子：
1.1
通讯作者：
Madsen LB
中科院分区：
文献类型：
--
作者：
Aakjær S;Bendstrup E;Ivarsen P;Madsen LB
弥漫性肺泡出血是系统性红斑狼疮的一种罕见但潜在致命的并发症。DAH的典型特征是咯血、呼吸困难、胸部X线或CT扫描显示的新浸润和血红蛋白下降。DAH见于不到2%的SLE患者，并具有高达70- 90%的高急性死亡风险。目前DAH的治疗是大剂量静脉注射皮质类固醇、环磷酰胺和广泛的支持治疗。在治疗中也经常考虑血浆置换。少数病例报告描述了SLE和DAH患者，其中单系列的利妥昔单抗（RTX），一种特异性抗CD 20抗原B细胞抗体，已成功用于治疗DAH。我们在这里介绍了第一例合并SLE、抗磷脂综合征（APS）和复发性DAH的患者，该患者通过持续RTX治疗成功控制。
Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal complication in systemic lupus erythematosus (SLE). DAH is typically characterized by hemoptysis, dyspnea, new infiltrates on chest x-rays or CT-scans and a drop in hemoglobin. DAH is seen in less than 2% of patients with SLE and carries a high acute mortality risk of up to 70–90%. The current treatment of DAH is high-dose intravenous corticosteroids, cyclophosphamide and extensive supportive care. Plasmapheresis is also often considered in the treatment. A few case reports have described patients with SLE and DAH in whom a single series of Rituximab (RTX), a specific anti-CD20-antigen B-cell antibody, successfully has been used to treat DAH. We here present the first case of a patient with combined SLE, antiphospholipid syndrome (APS) and recurrent DAH who was successfully controlled by continued treatment with RTX.