Rituximab: an emerging treatment for recurrent diffuse alveolar hemorrhage in systemic lupus erythematosus
Rituximab: an emerging treatment for recurrent diffuse alveolar hemorrhage in systemic lupus erythematosus
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DOI：
10.1177/0961203314564235
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发表时间：
2015-06-01
期刊：
影响因子：
2.6
通讯作者：
Simon, W.
中科院分区：
文献类型：
--
作者：
Tse, J. R.;Schwab, K. E.;Simon, W.
弥漫性肺泡出血（DAH）是系统性红斑狼疮（SLE）的一种罕见表现，并与高死亡率相关。治疗通常包括积极的免疫抑制与脉冲剂量类固醇，环磷酰胺和血浆置换治疗。尽管使用了多种药物治疗，死亡率仍然很高。我们报告一例52岁女性SLE患者在接受已故供者肾移植后，使用利妥昔单抗成功治疗后复发DAH。我们的报告强调了B细胞介导的免疫抑制在狼疮相关DAH中的病理生理重要性，并表明利妥昔单抗可能是治疗这种疾病的环磷酰胺的可行替代方案。我们还审查了其他八个报告的情况下，利妥昔单抗使用SLE相关DAH。
Diffuse alveolar hemorrhage (DAH) is a rare manifestation of systemic lupus erythematosus (SLE) and is associated with high mortality rates. Treatment typically consists of aggressive immunosuppression with pulse-dose steroids, cyclophosphamide, and plasma exchange therapy. Mortality rates remain high despite use of multiple medical therapies. We present a case of recurrent DAH in a 52-year-old female with SLE after a deceased donor renal transplant who was successfully treated with rituximab. Our report highlights the pathophysiologic importance of B-cell-mediated immunosuppression in SLE-associated DAH and suggests that rituximab may represent a viable alternative to cyclophosphamide in the treatment of this disease. We also review eight other reported cases of rituximab use in SLE-associated DAH.