利妥昔单抗致消化道穿孔1例

A case report of digestive tract perforation caused by rituximab

利妥昔单抗是一种针对CD20抗原的鼠源性免疫球蛋白单克隆抗体,现广泛应用于弥漫性大B细胞淋巴瘤(DLBCL)的治疗。其不良反应主要为胃肠道反应,但很少有出现胃肠道穿孔的病例。现国内外对此不良反应的文献多数与原发胃肠道淋巴瘤有关。胃肠道是非霍奇金淋巴瘤(NHL)目前最常见的结外累及部位,而对于胃肠道以外的淋巴瘤导致消化道穿孔的报道较少,但导致的后果比较严重。本研究报道1例DLBCL患者行利妥昔单抗治疗后出现消化道穿孔病例,汇报该患者的临床表现、实验室检查、影像学特点和治疗方案,并结合相关文献,探讨该药物的机制以及该病的诊断、治疗,为临床用药安全提供参考,减少不良反应的发生。

Rituximab is a mouse derived immunoglobulin monoclonal antibody against CD20 antigen,which is widely used in the treatment of diffuse large B-cell lymphoma(DLBCL).The main adverse reaction(ADR)is gastrointestinal reaction,but there are few cases of gastrointestinal perforation.At present,most of the literature about this ADR at home and abroad is related to primary gastrointestinal lymphoma.Gastrointestinal tract is the most common extranodal involvement site of non-Hodgkin lymphoma(NHL).However,there are few reports about gastrointestinal tract perforation caused by lymphoma outside gastrointestinal tract,but the consequences are more serious.A case of digestive tract perforation in a patient with DLBCL treated with rituximab is reported in this paper,and the clinical manifestations,laboratory examination,imaging features and treatment plan of the patient are reported.Meanwhile,combined with related literature,the mechanism of the drug and the diagnosis and treatment of the disease are discussed,which provides reference for clinical medication safety and reduces the occurrence of ADRs.