Inkqubo yeLupus Erythematosus (SLE)-02
Isigulana sisetyhini esineminyaka engama-20 ubudala esine-systemic lupus erythematosus (SLE) enzima kwaye ekhawulezayo. Ngaphandle konyango nge-hydroxychloroquine sulfate, i-azathioprine, i-mycophenolate mofetil, kunye ne-belimumab, ukusebenza kwakhe kwezintso kuye kwaba mandundu kwisithuba seenyanga ezintlanu, nto leyo eyakhokelela kwi-nephritis ebukhali eneproteinuria (ixabiso le-creatinine leeyure ezingama-24 lifikelela kwi-10,717 mg/g) kunye ne-hematuria encinci. Kwiiveki ezine ezilandelayo, inqanaba lakhe le-creatinine lenyuka laya kwi-1.69 mg / dl (uluhlu oluqhelekileyo lwe-0.41 ~ 0.81 mg / dl), luhamba ne-hyperphosphatemia kunye ne-renal tubular acidosis. I-renal biopsy ibonise inqanaba le-4 lupus nephritis. Isalathisi somsebenzi we-NIH eguquliweyo yayiyi-15 (ubuninzi be-24), kwaye i-NIH eguquguqukayo ye-chronicity index yayingu-1 (ubuninzi be-12). Isigulana sinciphise amanqanaba okuncedisana kunye nee-autoantibodies ezininzi emzimbeni wakhe, ezifana ne-antinuclear antibodies, i-anti-double-stranded DNA, i-anti-nucleosome, kunye ne-anti-histone antibodies.
Kwiinyanga ezisithoba emva koko, inqanaba le-creatinine lesigulana lenyuka laya kwi-4.86 mg/dl, lifuna i-dialysis kunye nonyango lwe-antihypertensive. Iziphumo zeLebhu zibonise i-SLE Disease Activity Index (SLEDAI) amanqaku e-23, ebonisa imeko enzima kakhulu. Ngenxa yoko, isigulane safumana unyango lwe-CAR-T. Inkqubo yonyango yaba ngolu hlobo lulandelayo:
- Iveki enye emva kokungena kweseli ye-CAR-T, izithuba phakathi kweeseshoni ze-dialysis zanda.
- Kwiinyanga ezintathu emva kokufakwa, inqanaba le-creatinine lehla ukuya kwi-1.2 mg/dl, kwaye iqondo eliqikelelwayo lokuhluzwa kwe-glomerular (eGFR) linyuke ukusuka kubuncinci be-8 ml/min/1.73m² ukuya kwi-24 ml/min/1.73m², ebonisa inqanaba le-3b isifo sezintso ezingapheliyo. Amayeza okulwa noxinzelelo lwegazi nawo aye ancitshiswa.
- Emva kweenyanga ezisixhenxe, iimpawu ze-arthritis zesigulane zancipha, izinto ezincedisayo ze-C3 kunye ne-C4 zibuyele ngokuqhelekileyo kwiiveki ezintandathu, kunye ne-anti-antinuclear antibodies, i-anti-dsDNA kunye nezinye i-autoantibodies zanyamalala. Umsebenzi we-renal wesigulane uphuculwe kakhulu, kunye ne-24-iyure ye-proteinuria iyancipha ukuya kwi-3400 mg, nangona yahlala iphakanyisiwe ekulandeleni kokugqibela, iphakamisa umonakalo ongenakuguqulwa we-glomerular. I-plasma albumin concentration yayiqhelekile, ingenayo i-edema; uhlalutyo lomchamo alubonisi zimpawu ze-nephritis, kwaye kwakungekho hematuria okanye iiseli ezibomvu zegazi. Isigulana ngoku siphinde saqalisa ubomi obuqhelekileyo.
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