利妥昔单抗联合糖皮质激素治疗寻常型天疱疮1例

doi:10.12337/zgkqjxjyzz.2025.06.012

中国口腔医学继续教育杂志 ›› 2025, Vol. 28 ›› Issue (6): 460-468.DOI: 10.12337/zgkqjxjyzz.2025.06.012

利妥昔单抗联合糖皮质激素治疗寻常型天疱疮1例

宋萌萌, 朱振来, 王新文, 刘青^*

口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔医学重点实验室,空军军医大学口腔医院口腔黏膜科

出版日期:2025-11-30 发布日期:2025-11-30
通讯作者: ^*刘青,联系方式：029-84772604,电子邮箱：liuqing@fmmu.edu.cn,通讯地址：陕西省西安市新城区长乐西路145号,710032

A Case Report of Rituximab Combined with Glucocorticoids in the Treatment of Pemphigus Vulgaris

Mengmeng Song, Zhenlai Zhu, Xinwen Wang, Qing Liu^*

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Oral Medicine, School of Stomatology, The Fourth Military Medical University, P.R. China

Online:2025-11-30 Published:2025-11-30
Contact: Qing Liu. Tel:029-84772604. Email: liuqing@fmmu.edu.cn. Address: No. 145 Changle West Road, Xincheng District, Xi’an 710032, Shaanxi Province, P.R. China.

摘要/Abstract

摘要： 目的：报道1例采用利妥昔单抗联合糖皮质激素治疗伴骨质疏松的寻常型天疱疮病例,为该类患者提供治疗参考。诊治经过：患者因合并重度骨质疏松,存在长期大剂量糖皮质激素使用禁忌。住院经系统评估后,为其制定静脉滴注利妥昔单抗联合口服糖皮质激素的个性化治疗方案。结果：治疗后患者口腔黏膜及皮肤损害均得到显著改善,在病情获得有效控制的同时实现了糖皮质激素快速减量。结论：对于黏膜主导型的寻常型天疱疮患者,尤其合并长期糖皮质激素使用禁忌者,利妥昔单抗联合糖皮质激素治疗方案显示出良好的疗效及安全性。

关键词: 天疱疮, 天疱疮疾病面积指数, 利妥昔单抗, 糖皮质激素, 联合治疗

Abstract: Objective: This article reports a case of severe pemphigus vulgaris with severe osteoporosis treated with rituximab combined with glucocorticoids, providing a reference for the treatment of such patients. Diagnosis and Treatment: The patient was contraindicated for long-term high-dose glucocorticoid therapy due to severe osteoporosis. After systematic evaluation during hospitalization, a personalized treatment regimen was established for intravenous rituximab combined with oral glucocorticoids. Results: After treatment, the oral mucosa and skin lesions were significantly improved, and the glucocorticoid was rapidly reduced while the disease was effectively controlled. Conclusions: For mucosal-predominant pemphigus, particularly in patients with contraindications to long-term glucocorticoid use, the combination therapy of rituximab and glucocorticoids demonstrates favorable efficacy and safety, while enabling rapid tapering of glucocorticoids.

Key words: pemphigus, pemphigus disease area index, rituximab, glucocorticoids, combined therapy

宋萌萌, 朱振来, 王新文, 刘青. 利妥昔单抗联合糖皮质激素治疗寻常型天疱疮1例[J]. 中国口腔医学继续教育杂志, 2025, 28(6): 460-468.

Mengmeng Song, Zhenlai Zhu, Xinwen Wang, Qing Liu. A Case Report of Rituximab Combined with Glucocorticoids in the Treatment of Pemphigus Vulgaris[J]. Chinese Journal of Stomatological Continuing Education, 2025, 28(6): 460-468.

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利妥昔单抗联合糖皮质激素治疗寻常型天疱疮1例

A Case Report of Rituximab Combined with Glucocorticoids in the Treatment of Pemphigus Vulgaris

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