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首页> 外文期刊>CEN Case Reports >Mizoribine as a safe and effective combined maintenance therapy with prednisolone for anti-neutrophil cytoplasmic antibody-associated vasculitis in a hemodialysis patient
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Mizoribine as a safe and effective combined maintenance therapy with prednisolone for anti-neutrophil cytoplasmic antibody-associated vasculitis in a hemodialysis patient

机译：咪唑立滨与泼尼松龙联合用于血液透析患者抗中性粒细胞胞浆抗体相关血管炎的安全有效联合治疗

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A 77-year-old man developed severe renal insufficiency due to proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA)-associated vasculitis, and was started on hemodialysis (HD). Because his renal insufficiency appeared to be irreversible, he was maintained on oral prednisolone (PSL) at 5mg/day. However, a disease flare-up with alveolar hemorrhage occurred. Serology revealed elevated levels of PR3-ANCA and C-reactive protein (CRP). The patient was given pulse therapy with a quarter dose of methylprednisolone (m-PSL) (250mg, 3days), followed by oral PSL at 15mg/day. As a supplemental treatment, he was given 25mg of mizoribine (MZR) immediately after each HD session. Subsequently, the levels of PR3-ANCA and CRP decreased, and the alveolar hemorrhage resolved. The dose of MZR to be given was determined by measuring the patient’s serum concentrations of MZR at various time points after the HD session. The maintenance dose of MZR was finally set at 50mg. At present, the oral PSL dosage has been tapered to 10mg/day, and the patient has achieved a state of remission without any side effects.
机译：一名77岁的男子因蛋白酶3抗中性粒细胞胞浆抗体（PR3-ANCA）相关的血管炎而严重肾功能不全，并开始进行血液透析（HD）。因为他的肾功能不全似乎是不可逆的，所以他维持口服泼尼松龙（PSL）的剂量为5mg /天。但是，发生了伴随肺泡出血的疾病发作。血清学检查显示PR3-ANCA和C反应蛋白（CRP）水平升高。患者接受了四分之一甲基强的松龙（m-PSL）（250mg，3天）的脉冲治疗，随后口服15mg /天的PSL。作为补充治疗，每次高清疗程后立即给予他25 mg咪唑立滨（MZR）。随后，PR3-ANCA和CRP的水平下降，肺泡出血得以解决。通过在HD疗程后的不同时间测量患者的MZR血清浓度，确定要给予的MZR剂量。最终将MZR的维持剂量设定为50mg。目前，口服PSL剂量已逐渐减少至10mg /天，患者已达到缓解状态，没有任何副作用。

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