口腔疾病防治2024，Vol.32Issue(8)：614-619,6.DOI:10.12016/j.issn.2096-1456.2024.08.006
甲泼尼龙联合吗替麦考酚酯治疗口腔黏膜类天疱疮1例报道及文献回顾
Methylprednisolone combined with mycophenolate mofetil for the treatment of oral mucosal pemphigoid:a case report and literature review
摘要
Abstract
Objective To investigate the application of mycophenolate mofetil(MMF)in oral mucosal pemphigoid and provide a clinical reference.Methods One case of glucocorticoids combined with MMF in the treatment of oral mucosal pemphigoid was reported,and the clinical application of MMF in oral mucosa-related bullous diseases was dis-cussed.Results One patient with a clinical diagnosis of"oral mucosal pemphigoid"was treated with methylpredniso-lone(36 mg,qd,morning dose)or combined hydroxychloroquine sulfate(0.1 g/time,bid)and thalidomide capsules(50 mg,qd,bedtime)and other drugs.The patient's disease was slowly controlled but prone to recurrence.The treat-ment regimen was immediately adjusted,i.e.,methylprednisolone(36 mg,qd,morning dose)was combined with MMF(0.5 g/time,bid)for 2 weeks,which resulted in ideal lesion healing control.After 8 weeks of methylprednisolone com-bined with MMF,the dose of methylprednisolone was gradually reduced to 12 mg,qd,and MMF was reduced to 0.5 g,qd,the patient's symptoms improved significantly,and no obvious lesions were found in the mouth.The dose was then reduced and maintained according to the principle of pemphigoid treatment.Methylprednisolone(8 mg,qd,morning dose)and MMF(0.5 g,qd)have been used for 6 months of maintenance treatment,and they are still being followed up.As yet,the patient's condition is stable without obvious lesions and new blisters,and no obvious side effects have been observed.A review of the literature shows that MMF is widely used in the field of dermatology to treat a variety of im-mune diseases,such as connective tissue diseases and autoimmune blistering diseases.According to the reports of ad-verse reactions to MMF,digestive system reactions are the most common adverse reactions;therefore,patients with ac-tive gastrointestinal diseases should be treated with caution,followed by bone marrow suppression,and it is recommend-ed to monitor liver function and blood routine in patients using MMF.The safety and efficacy of MMF for treating pem-phigoid involving the skin have been reported in the literature,but oral mucosal doctors still lack experience for treating mucous membrane pemphigoid.Conclusions As a new immunosuppressant,MMF has high safety and no obvious side effects and can be considered as a combination adjuvant drug for patients with severe clinical disease and refractory oral mucosal pemphigoid.关键词
类天疱疮/免疫性疾病/糖皮质激素/吗替麦考酚酯/免疫抑制剂/硫酸羟氯喹/沙利度胺胶囊/副作用Key words
pemphigoid/immune diseases/glucocorticoids/mycophenolate mofetil/immunosuppressants/hydroxychloroquine sulfate/thalidomide capsules/side effects分类
医药卫生引用本文复制引用
熊小琴,高峰,孟文霞..甲泼尼龙联合吗替麦考酚酯治疗口腔黏膜类天疱疮1例报道及文献回顾[J].口腔疾病防治,2024,32(8):614-619,6.基金项目
广东省基础与应用基础研究基金委员会青年基金项目(2021A1515111196) This study was supported by the grants from Youth Fund of Guangdong Basic and Applied Basic Research Foundation Committee(No.2021A1515111196). （2021A1515111196）
