ʻO ka Lupus Erythematosus Pūnaehana (SLE)-03

I ʻAukake 2016, ua loaʻa iā Ms. A, he 20 makahiki, nā kiko ʻulaʻula liʻiliʻi ma kona kino a me nā kuni pinepine, a he haʻahaʻa kona helu platelet, ʻehiku mahina ma hope o ka hānau ʻana. Ma hope o nā hoʻokolohua he nui ma nā haukapila kūloko, ua ʻike ʻia ʻo ia me ka systemic lupus erythematosus (SLE) ma kahi haukapila panalāʻau. I ʻOkakopa o ia makahiki hoʻokahi, ua hoʻomaka ʻo ia e loaʻa ka lāʻau lapaʻau ma kona haukapila kūloko.

"No nā makahiki ʻehiku i hala iho nei, ua pono iaʻu e kipa aku i ka haukapila i kēlā me kēia mahina no nā lāʻau lapaʻau, nā hoʻāʻo koko pinepine, nā hoʻāʻo mimi, a me nā lāʻau lapaʻau a me nā inikini mau, akā ua hoʻomau hou ke ʻano, he mea ʻeha loa ia," wahi a Ms. A. I ka hoʻāʻo ʻana e mālama i kona maʻi, ua lawe kāna kāne iā ia i kekahi mau haukapila, akā ʻaʻole i lawe mai nā kumukūʻai kiʻekiʻe i ka hōʻoluʻolu i kona ʻano. I ka hopena, ua loaʻa iā ia ka lupus nephritis a me ka encephalopathy, a i Kepakemapa 2022, ua hana ʻia ʻo ia i ke ʻoki lolo. I ka lohe ʻana e hiki i ka lāʻau lapaʻau CAR-T ke mālama i ka SLE, ua ʻimi ʻo Ms. A i ke kōkua mai kā mākou haukapila, kahi i nānā koke ai ka hui loea i kona ʻano.

Ua wehewehe ke kauka, "I ka wā i komo mua ʻia ai kēia maʻi, ua loaʻa iā ia ka edema laulā, ka proteinuria koʻikoʻi, a me nā antibodies maikaʻi. Ua hana ʻo ia i nā lāʻau lapaʻau hormone a me nā immunosuppressive kuʻuna, a me ʻehiku mau pōʻai o ka lāʻau lapaʻau biological, akā ʻaʻohe mea i kūleʻa. Ua loaʻa iā ia ka lupus encephalopathy, ka pulmonary hypertension, ka pulmonary fibrosis, a ua hōʻike kāna biopsy renal i ka lupus hana. Ua hōʻike kēia ʻaʻole kūleʻa nā lāʻau lapaʻau kuʻuna a me nā biological." Ke hoʻohālikelike ʻia me nā mea kemika kuʻuna a i ʻole nā ​​​​antibodies monoclonal, hiki i nā cell CAR-T ke komo i nā pale o ke kino, hoʻolaha ākea i loko o nā ʻiʻo, a hoʻopuka i kahi hopena cytotoxic, ʻoi aku hoʻi i nā cell B a i ʻole nā ​​​​​​cell plasma i loko o nā hakahaka ʻiʻo i hiki ʻole i nā antibodies monoclonal. Me ka ʻole o nā 'hua o ka maʻi,' e emi mālie ana nā autoantibodies o ka mea maʻi, hoʻi nā complements i ka maʻamau, a hōʻoluʻolu mālie a nalo paha nā hōʻailona. " No laila, ua hana maikaʻi ka mea maʻi i ka lāʻau lapaʻau CAR-T.

ʻĪ maila ʻo Ms. A, "I kēia manawa, ua nalowale nā ​​kiko ʻulaʻula ma koʻu kino, a ʻaʻole pono hou iaʻu nā lāʻau lapaʻau hormone a i ʻole nā ​​immunosuppressants. Ma mua, ua loaʻa iaʻu nā hoʻāʻo koko a me ka mimi pinepine, akā i kēia manawa, pono wale nō iaʻu i kēlā me kēia ʻeono mahina. Maikaʻi koʻu kūlana holoʻokoʻa, a maʻamau nā hōʻailona a pau. I kēia lā koʻu kipa ʻekolu ʻana, a maikaʻi nā hopena mai nā kipa ʻelua ma mua. Mahalo nui wau i nā limahana lapaʻau no ka hāʻawi ʻana mai iaʻu i kahi manawa ʻelua i ke ola."