Iguratimod in treatment of primary Sjögren’s syndrome concomitant with autoimmune hemolytic anemia:A case report

BACKGROUND Primary Sjögren's syndrome(pSS)concomitant with autoimmune hemolytic anemia(AIHA)but without eye and mouth dryness is exceedingly rare.Iguratimod(IGU)has been widely used in the treatment of pSS.However,there are few reports about the application of IGU in pSS concomitant with AIHA.CASE SUMMARY Here,we present the case of a patient with pSS concomitant with AIHA but without eye and mouth dryness.The patient was initially diagnosed with hyperplastic anemia and AIHA while pSS was missed,and was finally diagnosed with pSS concomitant with AIHA.The patient was treated with IGU along with prednisone and hydroxychloroquine,and her hemoglobin,reticulocytes and IgG returned to normal levels.CONCLUSION IGU was effective for and well tolerated by our patient with pSS concomitant with AIHA,and may be a promising therapy for the treatment of this disease.

一种从外周血单个核细胞中祛除低密度粒细胞并纯化T淋巴细胞的简易方法（英文）

目的:系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMCs)中的低密度粒细胞(LDGs)可以自发而过度地形成中性粒细胞胞外网状陷阱(NETs),而形成的NETs会降低T细胞激活的阈值。采用PBMCs做淋巴细胞研究时,所含的异常增多的LDGs可能会显著影响实验结果。因此需要了解其他自身免疫病中LDGs的比例,并需要一种简便地祛除PBMCs中LDGs的方法。创新点:首次提出LDGs清除的方法,验证了离心后贴壁法清除LDGs的有效性和可靠性。方法:采用流式细胞仪测定55例皮肌炎(DM)患者、15例多发性肌炎(PM)患者、42例类风湿关节炎(RA)患者、25例SLE患者(阳性对照)和19例健康对照(阴性对照)PBMCs中LDGs的比例。采用提高离心力、离心后贴壁和全血沉淀后再离心这三种方法祛除PBMCs中的LDGs,进一步比较各种方法的LDGs清除率和对PBMCs中T细胞的影响程度。清除T-SPOT.TB阳性患者PBMCs中LDGs后复测T-SPOT.TB,明确LDGs是否对T-SPOT.TB结果有影响。结论:本研究中DM、PM、RA和SLE患者PBMCs中LDGs比例普遍升高(图1)。清除PBMCs中LDGs后,T-SPOT.TB显著降低(图2)。离心后贴壁法不但能最有效地清除LDGs,且对PBMCs中T细胞的比例影响最小(图3~5)。综上所述,PBMCs中LDGs的比例在DM、PM、RA和SLE患者中普遍增高;采用PBMCs做T细胞相关研究时LDGs通过形成NETs对T细胞激活的影响不能忽视;离心后贴壁法可以简单而高效地清除PBMCs中的LDGs。