1例38岁男性强直性脊柱炎患者接受阿达木单抗40 mg皮下注射、1次/2周治疗,21个月后出现发热、乏力、右侧颈部淋巴结和咽喉部肿痛。实验室检查示结核菌素试验强阳性,结核杆菌γ-干扰素释放试验1 911.98 ng/L,红细胞沉降率27 mm/1 h。右侧颈部淋巴结活检示淋巴结肉芽肿性炎。诊断为颈部淋巴结结核。考虑与阿达木单抗有关。停用该药,予抗结核治疗。次日,患者体温恢复正常,5 d后颈部淋巴结、咽喉部肿痛及乏力等症状缓解。45 d后门诊复查,患者上述症状消失。
A 38-year-old male patient with ankylosing spondylitis received subcutaneous injection of adalimumab 40 mg once every 2 weeks. After 21 months of medication, the patient developed fever, fatigue, swelling, and pain in the right neck lymph node and throat. Laboratory tests showed that the tuberculin test was strong positive, mycobacterium tuberculosis γ-interferon release test was 1 911.98 ng/L, and erythrocyte sedimentation rate was 27 mm/1 h. The biopsy of right neck lymph node showed granulomatous inflammation of the lymph node. The patient was diagnosed with cervical lymph node tuberculosis, which was considered to be related to adalimumab. The drug was stopped and anti-tuberculosis treatments were given. The next day, the patient′s temperature returned to normal. After 5 days, the swelling and pain of cervical lymph nodes and throat, and the fatigue were relieved gradually. After 45 days, the above symptoms in the patient disappeared.
吴桂英,穆桂兰,乌日力嘎,等. 阿达木单抗诱发颈部淋巴结结核[J]. 药物不良反应杂志,2025,27(03):188-189.
DOI:10.3760/cma.j.cn114015-20240103-00002版权归中华医学会所有。
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