阿达木单抗治疗克罗恩病致病毒性脑炎1例

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【中图分类号】R975 【文献标识码】A

【Abstract】This report presents a rare case of viral encephalitis resulting from co-infection with human herpesvirus 7 （HHV-7）and Epstein-Barr virus （EBV） in a 16-year-old patient with Crohn's disease following adalimumab therapy. The patient was treated with adalimumab， with an initial subcutaneous dose of 160mg ，followed by 80mg at week 2，and maintenance doses of 40mg every two weeks， three months after initiating treatment， the patient developed symptoms including headache，diplopia，and signs of intracranial hypertension. Metagenomic sequencing of the cerebrospinal fluid identified HHV-7and EBVas the causative pathogens， with cranial magnetic resonance imaging supporting the diagnosis of viral encephalitis. Targeted antiviral therapy and supportive care led to significant resolution of neurological symptoms. Using the Naranjo's Assessment Scale，the asociationbetween adalimumaband viral encephalitis was evaluated，yieldinga score of 5， indicating a "probable"causal link.This case underscores the importance of vigilant monitoring for rare central nervous system viral infections in patients with Crohn's disease receiving tumor necrosis factor inhibitors.

【Keywords】 Adalimumab; Crohn’s disease; Viral encephalitis; Adverse drug reaction

阿达木单抗是一种重组全人源化肿瘤坏死因子（tumor necrosis factor- ∇⋅a ，TNF- α⋅a ）单克隆抗体，作为治疗克罗恩病（Crohn'sdisease，CD）的重要生物制剂，显著改善了中重度CD患者的临床结局，但其免疫抑制特性可能增加机会性感染风险，包括中枢神经系统感染等]。（剩余10182字）