利妥昔单抗治疗抗信号识别颗粒自身抗体阳性免疫介导坏死性肌炎5例分析

Rituximab in the treatment of anti-SRP antibody positive immune-mediated necrotizing myositis:a review of 5 cases

目的观察抗信号识别颗粒抗体(抗SRP抗体)阳性免疫介导坏死性肌炎患者对利妥昔单抗的治疗反应及安全性。方法研究收集了5例2022年3月至2023年10月在中日友好医院风湿免疫科住院并接受利妥昔单抗治疗的抗SRP抗体阳性免疫介导坏死性肌炎患者5例,回顾他们的临床特征、对利妥昔单抗的治疗应答及不良反应。结果在接受利妥昔单抗治疗6个月后,5例患者中有3例有效,且均为显著有效,1例无效;1例在治疗5个月后死于"肺部感染";1例患者出现结核潜伏感染。结论利妥昔单抗治疗抗SRP抗体阳性免疫介导坏死性肌炎有效,不良反应发生率较低,总体获益大于风险。

ObjectiveTo observe the therapeutic response and safety of rituximab in patients with anti-SRP antibody positive immune-mediated necrotizing myositis.MethodsWe identified five patients with anti-SRP antibody positive immune-mediated necrotizing myositis who received rituximab treatment in the rheumatology and immunology department of China-Japan Friendship Hospital from March 2022 to October 2023,and reviewed their clinical characteristics,treatment response to rituximab and adverse reaction.ResultsAfter 6 months of treatment with rituximab,3 of 5 patients were effective and all were significantly effective,1 patient showed no response,1 patient died of"pulmonary infection"after 5 months of treatment,and 1 patient developed latent tuberculosis infection.ConclusionRituximab is effective in the treatment of anti-SRP antibody positive immune-mediated necrotizing myositis,with a low incidence of adverse reactions and overall benefits outweighing risks.