Hạ kali máu sau khi sử dụng rituximab trong hội chứng thận hư: hai báo cáo ca bệnh

BMC Nephrology - Tập 24 - Trang 1-4 - 2023
Yiyun Song1, Lin Ding1, Xin An1, Yi Zhao1, Xianhua Li1, Xiangdong Yang1, Xiaoyan Xiao1
1Department of Nephrology, Qilu Hospital of Shandong University, Jinan, PR China

Tóm tắt

Rituximab, một kháng thể đơn dòng chống CD20 dạng khimer, là phương pháp điều trị hiệu quả cho hội chứng thận hư. Hạ kali máu là một phản ứng bất lợi hiếm gặp ở những bệnh nhân được điều trị bằng rituximab, mặc dù đã có nhiều báo cáo về các sự kiện bất lợi cấp tính và mãn tính liên quan đến việc sử dụng rituximab. Chúng tôi xin báo cáo hai trường hợp hạ kali máu có triệu chứng sau khi truyền rituximab tĩnh mạch tại trung tâm của chúng tôi, nhằm giúp các chuyên gia y tế xem xét khả năng hạ kali máu cấp tính sau khi sử dụng rituximab, theo dõi kịp thời nồng độ kali và xây dựng một kế hoạch điều trị thích hợp.

Từ khóa


Tài liệu tham khảo

Kodner C. Diagnosis and management of nephrotic syndrome in adults. Am Fam Physician. 2016;93(6):479–85. Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ. 2008;336(7654):1185–9. Taylor RP, Lindorfer MA. Immunotherapeutic mechanisms of anti-CD20 monoclonal antibodies. Curr Opin Immunol. 2008;20(4):444–9. Edwards JC, et al. Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med. 2004;350(25):2572–81. Kattah AG, Fervenza FC, Roccatello D. Rituximab-based novel strategies for the treatment of immune-mediated glomerular diseases. Autoimmun Rev. 2013;12(8):854–9. Ronco P, et al. Membranous nephropathy. Nat Rev Dis Primers. 2021;7(1):69. KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases.Kidney Int, 2021. 100(4s): p.S1-s276. Teisseyre M, et al. Advances in the management of primary Membranous Nephropathy and Rituximab-Refractory Membranous Nephropathy. Front Immunol. 2022;13:859419. Basu B, et al. Efficacy of Rituximab vs Tacrolimus in Pediatric corticosteroid-dependent nephrotic syndrome: a Randomized Clinical Trial. JAMA Pediatr. 2018;172(8):757–64. van Vollenhoven RF, et al. Long-term safety of rituximab in rheumatoid arthritis: 9.5-year follow-up of the global clinical trial programme with a focus on adverse events of interest in RA patients. Ann Rheum Dis. 2013;72(9):1496–502. Levin AS, et al. Reactions to Rituximab in an outpatient infusion Center: a 5-Year review. J Allergy Clin Immunol Pract. 2017;5(1):107–113e1. Kasi PM, et al. Clinical review: serious adverse events associated with the use of rituximab - a critical care perspective. Crit Care. 2012;16(4):231. Ruggenenti P, et al. Rituximab in idiopathic membranous nephropathy. J Am Soc Nephrol. 2012;23(8):1416–25. Iijima K, et al. Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2014;384(9950):1273–81. Guzzi F, et al. Hypokalemia after Rituximab Administration in Steroid-Dependent Nephrotic Syndrome: a Case Report. Front Pharmacol. 2020;11:915. Shimada K, et al. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone combined with high-dose methotrexate plus intrathecal chemotherapy for newly diagnosed intravascular large B-cell lymphoma (PRIMEUR-IVL): a multicentre, single-arm, phase 2 trial. Lancet Oncol. 2020;21(4):593–602. Verzicco I, et al. Electrolyte Disorders Induced by Antineoplastic Drugs. Front Oncol. 2020;10:779. Huang CL, Kuo E. Mechanism of hypokalemia in magnesium deficiency. J Am Soc Nephrol. 2007;18(10):2649–52. Stein MN, et al. Androgen synthesis inhibitors in the treatment of castration-resistant prostate cancer. Asian J Androl. 2014;16(3):387–400. Liamis G, Filippatos TD, Elisaf MS. Electrolyte disorders associated with the use of anticancer drugs. Eur J Pharmacol. 2016;777:78–87. Schneeweiss A, et al. Phase ib study evaluating safety and clinical activity of the anti-HER3 antibody lumretuzumab combined with the anti-HER2 antibody pertuzumab and paclitaxel in HER3-positive, HER2-low metastatic breast cancer. Invest New Drugs. 2018;36(5):848–59. Jhaveri KD, et al. Renal effects of novel anticancer targeted therapies: a review of the Food and Drug Administration adverse event reporting system. Kidney Int. 2016;90(3):706–7. Cao Y, et al. Meta-analysis of incidence and risk of hypokalemia with cetuximab-based therapy for advanced cancer. Cancer Chemother Pharmacol. 2010;66(1):37–42. Wang J, et al. An intermediate-conductance ca(2+)-activated K (+) channel mediates B lymphoma cell cycle progression induced by serum. Pflug Arch: Eur J Physiol. 2007;454(6):945–56. Wang L-H, et al. Rituximab inhibits Kv1.3 channels in human B lymphoma cells via activation of FcγRIIB receptors. Biochim Biophys Acta. 2012;1823(2):505–13. Caillot F, et al. Long-term increase of Kcnn4 Potassium Channel Surface expression on B cells in Pemphigus Patients after Rituximab Treatment. J Invest Dermatol. 2018;138(12):2666–8.