中国麻风皮肤病杂志 ›› 2023, Vol. 39 ›› Issue (7): 508-511.doi: 10.12144/zgmfskin202307508

• 临床研究 • 上一篇    下一篇

中重度特应性皮炎患者应用度普利尤单抗治疗后发生风湿性多肌痛一例

杨子靖,潘萌,赵肖庆   

  1. 上海交通大学医学院附属瑞金医院皮肤科,上海,200025
  • 出版日期:2023-07-15 发布日期:2023-07-05

Dupilumab-induced immune drifting from atopic dermatitis to polymyalgia rheumatica: a case report

YANG Zijing, PAN Meng, ZHAO Xiaoqing   

  1. Department of Dermatology, Shanghai Jiao Tong University School of Medicine Affiliated Ruijin Hospital, Shanghai 200025, China
  • Online:2023-07-15 Published:2023-07-05

摘要: 我们报道一例罕见的特应性皮炎患者经度普利尤单抗治疗后发生风湿性多肌痛的病例。患者,女,66岁,确诊为中重度AD,使用度普利尤单抗治疗后第48周出现双肩关节疼痛、全身肌肉酸痛伴晨僵,持续4周以上。查体示双侧肩关节主动外展受限,双侧髋关节、膝关节主动屈曲及伸展轻度受限。辅助检查示红细胞沉降率、C-反应蛋白升高,肌酸激酶正常,类风湿因子及抗环瓜氨酸肽蛋白抗体均阴性。综上诊断为风湿性多肌痛,考虑与度普利尤单抗治疗有关。给予小剂量糖皮质激素、甲氨蝶呤口服,肌痛、皮疹和瘙痒均得到良好控制。

关键词: 风湿性多肌痛, 特应性皮炎, 度普利尤单抗, 免疫漂移

Abstract: We report a case of dupilumab-induced immune drifting from atopic dermatitis to polymyalgia rheumatica. A 66-year-old female presented with bilateral shoulder pain, widespread myalgia and morning stiffness for 4 weeks. She has had a history of moderate-to-severe atopic dermatitis and was treated with dupilumab over the past 48 weeks. Physical examination revealed limitation of active shoulder, hip and knee abduction but the muscle strength was normal. Laboratory findings showed elevated levels of erythrocyte sedimentation rate, C-reactive protein, while creatine kinase, rheumatoid factor and anti-cyclic peptide containing citrulline were of normal value. The patient was treated with low dose of prednisone, methotrexate, and other supportive treatment and the myalgias, rash and pruritus improved.

Key words: polymyalgia rheumatica, atopic dermatitis, dupilumab, immune drifting