作者:N Morel 翻譯:武東 審校:金銀姬
摘要 目的:心包受累是系統(tǒng)性紅斑狼瘡的一個常見表現(xiàn),。越來越多的證據(jù)顯示秋水仙堿治療急性或復(fù)發(fā)性心包炎是有效的,。我們首次報道了狼瘡合并心包炎并接受秋水仙堿治療的10個病例。
方法: 回顧性研究納入標準:診斷系統(tǒng)性紅斑狼瘡,,心包炎,,并接受秋水仙堿治療的患者。
結(jié)果: 我們納入秋水仙堿治療SLE合并心包炎的10例患者(9例女性,,平均年齡35?±?12),。其中2例患者心包炎是其狼瘡的首發(fā)表現(xiàn),其他8例狼瘡病程中位數(shù)為2.5年(15天到13年),,接受潑尼松治療(7例,,2-30mg/d), 羥氯喹(7例),,硫唑嘌呤(3例),,甲氨蝶呤(2例),和霉酚酸酯(1例),。6例患者心包炎與SLE其他癥狀相關(guān)。7例患者由于應(yīng)用秋水仙堿避免了激素的使用(2例)或加量(5例),;2例患者激素加量極少,。秋水仙堿1mg,療程中位數(shù)為39天(10天-54個月)。開始秋水仙堿治療后癥狀完全緩解的中位時間為2.5天(1-30天),。為避免復(fù)發(fā)6例患者接受了秋水仙堿的維持治療,,并且沒有再次復(fù)發(fā)。
結(jié)論: 秋水仙堿治療系統(tǒng)性紅斑狼瘡合并心包炎可能是安全有效的,,可作為替代激素的備選藥物,。這些初步結(jié)果需要更大更長時間的后續(xù)研究來加以證實。
附原文: Abstract Objectives Pericardial involvement is a frequent manifestation of systemic lupus erythematosus (SLE). Growing evidence suggests that colchicine may be useful for acute or recurrent pericarditis. We report for the first time a series of 10 consecutive cases of SLE with pericarditis treated with colchicine.Methods Inclusion criteria in this retrospective study were diagnosis of SLE, pericarditis and receiving colchicine.Results We included 10 consecutive cases of SLE with pericarditis treated with colchicine (nine women, mean age at the index pericarditis 35?±?12 years). Pericarditis was the initial manifestation of SLE for two patients, whereas eight patients had SLE lasting for a median of 2.5 years (15 days to 13 years) and had received prednisone (n?=?7, 2–30?mg/d), hydroxychloroquine (n?=?7), azathioprine (n?=?3), methotrexate (n?=?2), and mycophenolate mofetil (n?=?1).For six patients, pericarditis was associated with other SLE manifestations. Altogether, colchicine avoided the use (n?=?2) or increase in dosage (n?=?5) of steroids in seven cases; the increase in steroids dosage was minimal for two patients. Colchicine 1?mg was given for a median of 39 days (10 days to 54 months). Symptoms completely resolved after a median of 2.5 days (1–30 days) after initiation of colchicine. Colchicine was maintained or resumed in six patients to prevent recurrence, with no further relapse.Conclusions Colchicine may be safe and effective in treating SLE pericarditis and used as a steroids-sparing agent. These preliminary results need to be confirmed in a larger study with longer follow-up.
引自:N Morel,M Bonjour,V Le Guern et al.Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases. Lupus December 2015 vol. 24 no. 14 1479-1485
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