超小剂量利妥昔单抗治疗ANCA相关性血管炎一例

ANCA Associated Vasculitis Treated with Ultra⁃low Dose Rituximab:A Case Report

本文报道一例肺、肾受累的抗中性粒细胞胞浆抗体(antineutrophil cytoplasmic antibodies, ANCA)相关性血管炎患者,给予经典的糖皮质激素、环磷酰胺、血浆置换诱导缓解治疗有效。该患者在使用硫唑嘌呤维持治疗期间共出现2次感染,后换用超小剂量(100 mg/次)利妥昔单抗维持治疗病情稳定。个体化利妥昔单抗治疗ANCA相关性血管炎效果显著,同时避免了过度免疫抑制,减轻了患者的经济负担。本例患者的诊疗经验有助于提高临床医生在ANCA相关性血管炎维持治疗方面的认识。

We reported a case of ANCA-associated vasculitis with pulmonary and renal involvement that was effectively treated with glucocorticoids,cyclophosphamide,and plasma exchange therapy.The patient suf-fered two infections during maintenance treatment with azathioprine and was later switched to ultralow-dose(100 mg)rituximab to keep the disease in remission.Individualized rituximab therapy is effective in treating ANCA-associated vasculitis,while avoiding excessive immunosuppression,and reducing the financial burden.The diagnosis and treatment of this patient may help clinicians improve their understanding of maintenance ther-apy for ANCA-associated vasculitis.