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干扰素α诱发系统性红斑狼疮的临床特征及文献复习

Clinical characteristics of interferon alpha induced system lupus erythromatosis and literature review

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【作者】 袁子薇周明宣高锦团

【Author】 YUAN Zi-wei,ZHOU Ming-xuan,GAO Jin-tuan.The Second Clinical Medical College,Fujian Medical University,Quanzhou 362000,China

【机构】 福建医科大学第二临床医学院福建医科大学附属第二医院华侨病房

【摘要】 目的提高对干扰素α(IFN-α)诱发系统性红斑狼疮(SLE)的认识。方法分析我院收治、随访的1例IFN-α治疗慢性乙型肝炎(CHB)诱发SLE的病例并复习相关文献。结果患者女,25岁,聚乙二醇IFN-α治疗CHB 58周,获得生物化学、病毒学应答,HBeAg、HBsAg血清学转换。停IFN-α2周后出现发热、关节痛,尿蛋白阳性,抗核抗体、抗ds-DNA抗体阳性,肾脏穿刺病理示狼疮性肾炎Ⅳ-G(A)型,诊断SLE,糖皮质激素联用霉酚酸酯治疗后SLE缓解,未用抗乙型肝炎病毒药物,CHB持续应答。结论 IFN-α可诱发SLE,IFN-α相关SLE的临床表现与一般SLE相似,临床医师应了解IFN-α相关自身免疫性疾病的特征并及时停药,免疫抑制剂治疗有效。

【Abstract】 Objective To improve the recognition of systemic lupus erythromatosis(SLE)induced by interferon-α(IFN-α).Methods The clinical manifestation of 1 case of IFN-α induced SLE was presented and literatures were reviewed.Results A 25-year-old woman was treated with PegINF-α-2b for chronic hepatitis B(CHB),CHB obtained biochenmical and virological response with HBeAg positive converted to HBeAb and HBsAg positive to HBsAb.The patient had fever,arthralgia and proteinuria after ceased IFN-α treatment for 2 weeks,laboratory studies revealed antinuclear antibody and anti ds-DNA antibody were positive,the renal biopsy specimens showed lupus nephritisⅣ-G(A),she was given prednisone with mycophenolate mofetil,SLE obtained remission with sustained response of CHB.Conclusions IFN-α therapy can induce SLE,the clinical and laboratory features of IFN-α-induced SLE resembles idiopathic SLE,clinicians should be aware of potential autoimmune side effects of IFN-α therapy.Prompt recognition and withdraw of IFN-α is important in the treatment,immunosuppressive agents may improve the prognosis.

【关键词】 红斑狼疮,系统性干扰素
【Key words】 Lupus erythromatosis,systemicInterferon
  • 【文献出处】 中华临床医师杂志(电子版) ,Chinese Journal of Clinicians(Electronic Edition) , 编辑部邮箱 ,2012年04期
  • 【分类号】R593.241
  • 【被引频次】2
  • 【下载频次】119
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