| 引用本文: | 张卫琴,赵华伟,王珍珍,高峰,袁哲锋.托珠单抗治疗1例儿童难治性抗N-甲基-D-天冬氨酸受体脑炎的病例报告及文献复习[J].中国现代应用药学,2024,41(6):834-838. |
| ZHANG Weiqin,ZHAO Huawei,WANG Zhenzhen,GAO Feng,YUAN Zhefeng.A Case Report and Literature Review of A Child with Refractory Anti-N-methyl-D-aspartate Receptor Encephalitis Treated with Tocilizumab[J].Chin J Mod Appl Pharm(中国现代应用药学),2024,41(6):834-838. |
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| 摘要: |
| 目的 探讨托珠单抗治疗1例儿童难治性抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor，NMDAR)脑炎的安全性及有效性，为治疗该疾病提供参考。方法 回顾性分析浙江大学医学院附属儿童医院1例儿童难治性抗NMDAR脑炎的临床表现、诊治经过及应用托珠单抗的安全性及有效性，并结合相关文献复习加以讨论。结果 该患儿应用了2次大剂量甲泼尼龙、丙种球蛋白及6次利妥昔单抗后临床症状无好转，应用6次托珠单抗后，改良Rankin量表(mRS)评分有改善，无不良反应。结论 托珠单抗作为升级的二线免疫治疗药物对难治性抗NMDAR脑炎治疗有效，耐受性好，是一种具备潜力的治疗手段之一。 |
| 关键词: 托珠单抗 儿童 难治性 抗NMDAR脑炎 |
| DOI：10.13748/j.cnki.issn1007-7693.20232480 |
| 分类号:R969.3 |
| 基金项目:国家自然科学基金青年科学基金项目(82003720)；浙江省基础公益研究计划项目(LYY22H310002)；浙江省新一轮卫生高层次人才培养工程(2022年度医坛新秀) |
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| A Case Report and Literature Review of A Child with Refractory Anti-N-methyl-D-aspartate Receptor Encephalitis Treated with Tocilizumab |
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ZHANG Weiqin1, ZHAO Huawei2, WANG Zhenzhen1, GAO Feng1, YUAN Zhefeng1
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1.Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Department of Neurology, b.Department of Pharmacy, Hangzhou 310052, China;2.Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Department of Pharmacy, Hangzhou 310052, China
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| Abstract: |
| OBJECTIVE To explore the safety and efficacy of tocilizumab in the treatment of refractory anti-N-methyl-D-aspartate receptor encephalitis in children, and to provide reference for the treatment of this disease. METHODS The clinical manifestations, diagnosis and treatment, safety and efficacy of tocilizumab in a case of refractory anti-NMDAR encephalitis in Children’s Hospital, Zhejiang University School of Medicine were analyzed retrospectively, and the relevant literature was reviewed. RESULTS The clinical symptoms of the patient were not improved after 2 doses of methylprednisolone, immunoglobulin and 6 doses of rituximab. After 6 doses of tocilizumab, the modified Rankin scale(mRS) score was improved without adverse reactions. CONCLUSION Tocilizumab, as a escalation second-line immunotherapy, is effective and well tolerated in the treatment of refractory anti-NMDAR encephalitis. It is one of the potential therapeutic means. |
| Key words: tocilizumab children refractory anti-NMDAR encephalitis |
