贝利尤单抗联合多靶点治疗儿童系统性红斑狼疮1例

A case report of systemic lupus erythematosus in a pediatric patient treated with combination of belimumab and multi-target therapy

目的:探讨贝利尤单抗治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)患儿的有效性和安全性。方法:回顾2021年11月—2022年7月本院使用贝利尤单抗联合多靶点治疗1例SLE儿童8个月过程,收集患者的基线临床资料,8次用药后的实验室检查结果和基础治疗情况。分析患儿补体C3、补体C4、尿蛋白定量水平和泼尼松用量。结果:该患儿系系统性红斑狼疮伴狼疮性肾炎和神经精神性狼疮,起病急危重,经过8次贝利尤单抗联合多靶点治疗,补体C3、补体C4呈升高趋势,尿蛋白定量水平和泼尼松用量均下降。通过8个月的治疗甲泼尼龙用量减为4 mg/次,1次/2 d,快速减激素过程中没有出现病情复发。结论:及时给予贝利尤单抗能使患者临床症状明显减轻,特异性血清学指标逐步趋于正常;后续给予贝利尤单抗可减少基础治疗药物的种类和用量,同时未增加不良反应。

Objective:To investigate the clinical efficacy and safety of belimumab(BLM)in pediatric patients with systemic lupus erythematosus(SLE).Methods:Reviewed the 8-month course of treatment of a child with SLE using belimumab in combination with multitargeting in our hospital from November 2021 to July 2022,and collected the baseline clinical data of the patient,laboratory results,and basic treatment after 8 doses of the drug.Complement C3 and C4 levels,quantitative urine protein levels,and prednisone dosage were analyzed in the child.Results:The child had systemic lupus erythematosus with lupus nephritis and neuropsychiatric lupus,with acute and critical disease onset.After 8 sessions of treatment with belimumab combined with multi-targeted therapy,the complement C3 and C4 levels increased,and the quantitative level of urinary proteins and prednisone dosage decreased.The methylprednisolone dosage was reduced to 4 mg/dose once/2 d through 8 months of treatment,and there was no recurrence of the disease during the rapid hormone reduction.Conclusions:Timely administration of belimumab resulted in significant reduction in clinical symptoms and gradual normalization of specific serological indices.Subsequent administration of belimumab reduced the type and dosage of the basic therapeutic drugs without increasing adverse effects.