Tumour necrosis factor inhibitor-associated sinusitis.
Tumour necrosis factor inhibitor-associated sinusitis.
复制标题
肿瘤坏死因子抑制剂相关性鼻窦炎。
DOI：
10.4193/rhin13.074
复制
发表时间：
2014
期刊：
影响因子：
7.2
通讯作者：
T. Yamasoba
中科院分区：
文献类型：
--
作者：
S. Yoshihara;K. Kondo;K. Kanaya;K. Suzukawa;S. Baba;M. Toma‐Hirano;S. Kikuta;Y. Iwasaki;K. Fujio;T. Yamasoba
目的
描述与使用肿瘤坏死因子 (TNF) 抑制剂相关的慢性鼻窦炎的特征。
方法论
对 2003 年至 2011 年间病历的回顾性审查显示，有 5 名患者在开始使用 TNF 抑制剂后出现慢性鼻窦炎，需要进行鼻科评估和治疗。
结果
与 TNF 抑制剂相关的难治性鼻窦炎的发生率约为 2%。在确定的五名患者中，四名患者接受依那西普治疗，一名患者接受英夫利昔单抗治疗。上颌窦最常受累，三例鼻窦分泌物培养显示铜绿假单胞菌。尽管持续使用TNF抑制剂，两名患者的鼻窦炎在抗生素药物治疗后表现出改善，而另外两名患者的鼻窦炎对抗生素药物产生耐药性。另一位患者在通过内窥镜鼻窦手术完全缓解既往慢性鼻窦炎后出现鼻窦炎复发，仅在停止使用TNF抑制剂后才出现缓解。
结论
与TNF抑制剂相关的慢性鼻窦炎被认为是一种新的疾病实体，并且由于TNF抑制剂的使用增加，该疾病将变得更加常见。
AIM
To describe the features of chronic sinusitis associated with the use of tumour necrosis factor (TNF) inhibitors.
METHODOLOGY
A retrospective review of the medical records between 2003 and 2011 revealed that five patients had developed chronic sinusitis after the start of TNF inhibitor administration and required rhinological evaluation and treatment.
RESULTS
The incidence of refractory sinusitis associated with TNF inhibitors was approximately 2%. Of the five patients identified, four patients were medicated with etanercept and one with infliximab. The maxillary sinus was most commonly involved and cultures of the sinus discharge revealed Pseudomonas aeruginosa in three cases. Two patients showed improvement of sinusitis with antibiotic medication, despite the continuous use of TNF inhibitor, while in two other patients, sinusitis was resistant to antibiotic medication. Another patient who had developed recurrence of sinusitis after complete remission of previous chronic sinusitis by endoscopic sinus surgery showed remission only after cessation of TNF inhibitor.
CONCLUSION
Chronic sinusitis associated with TNF inhibitors is considered to be a new disease entity, and it will become more common due to the increasing use of TNF inhibitors.