Successful Management of Obstructive Jaundice due to Gallstones with Eculizumab in a Patient with Paroxysmal Nocturnal Hemoglobinuria
Successful Management of Obstructive Jaundice due to Gallstones with Eculizumab in a Patient with Paroxysmal Nocturnal Hemoglobinuria
复制标题
DOI：
10.2169/internalmedicine.51.8202
复制
发表时间：
2012-01-01
影响因子：
1.2
通讯作者：
Katayama, Yoshio
中科院分区：
文献类型：
--
作者：
Kawano, Hiroki;Minagawa, Kentaro;Katayama, Yoshio
阵发性夜间血红蛋白尿（PNH）使患者容易发生血管内溶血和血栓形成，在紧张的情况下可能危及生命。Eculizumab是一种抑制补体蛋白C5的人源化单克隆抗体，已被评估为治疗PNH的新方法。我们在此描述一位59岁的日本女性，她患有典型的PNH，她曾成功地使用eculizumab治疗，但后来发展为胆结石引起的急性胆囊炎/胆管炎。虽然胆囊切除术后需要内镜治疗的严重梗阻性黄疸很复杂，但没有观察到严重的血管内溶血和血栓形成。因此，应慎重考虑在PNH患者围手术期使用eculizumab。
Paroxysmal nocturnal hemoglobinuria (PNH) makes patients susceptible to intravascular hemolysis and thrombosis, and it can be life-threatening in stressful situations. Eculizumab, a humanized monoclonal antibody that inhibits the complement protein C5, has been evaluated as a novel therapy for PNH. We herein describe the case of a 59-year-old Japanese woman with classic PNH, who had been successfully treated with eculizumab, but who later developed acute cholecystitis/cholangitis from gallstones. Although the severe obstructive jaundice requiring endoscopic therapy following cholecystectomy was complicated, critical intravascular hemolysis and thrombosis were not observed. Therefore, utilizing eculizumab during the peri-operative management of PNH patients should be carefully taken into consideration.