Cursiefen Claus, Grunke Mathias, Dechant Claudia, Antoni Christian, Jünemann Anselm, Holbach Leonard M
Department of Ophthalmology and University Eye Hospital Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Am J Ophthalmol. 2002 Aug;134(2):270-1. doi: 10.1016/s0002-9394(02)01499-x.
To demonstrate a patient developing multiple bilateral eyelid molluscum contagiosum lesions after initiation of TNFalpha-antibody therapy for rheumatoid arthritis.
Single interventional case report.
Clinical, histopathologic, and immunologic-serological findings are presented.
A 67-year-old patient with a 5-year history of rheumatoid arthritis had been treated with prednisone and methotrexate for the last 5 years. After initiation of additional TNFalpha-antibody treatment, complaints from rheumatoid arthritis subsided, but multiple bilateral molluscum contagiosum lesions of upper and lower eyelids occurred despite normal or only slightly reduced CD(4) (420-178/ microl) and CD(8) counts (143-58/microl). Histopathologic evaluation of the excised warts confirmed the clinical diagnosis. Under continued therapy, the warts have been recurring for 12 months.
TNFalpha-antibody treatment for rheumatoid arthritis may compromise the host response to molluscum contagiosum, especially if methotrexate is given additionally. Patients should be informed about this potential complication.
展示一名类风湿关节炎患者在开始使用肿瘤坏死因子α抗体治疗后出现多发性双侧眼睑传染性软疣病变。
单例介入病例报告。
呈现临床、组织病理学和免疫血清学检查结果。
一名有5年类风湿关节炎病史的67岁患者在过去5年中接受泼尼松和甲氨蝶呤治疗。在开始额外的肿瘤坏死因子α抗体治疗后，类风湿关节炎症状减轻，但尽管CD4（420 - 178/微升）和CD8计数正常或仅略有降低（143 - 58/微升），上下眼睑仍出现多发性双侧传染性软疣病变。切除疣体的组织病理学评估证实了临床诊断。在持续治疗下，疣体已反复出现12个月。
类风湿关节炎的肿瘤坏死因子α抗体治疗可能会损害宿主对传染性软疣的反应，尤其是在同时给予甲氨蝶呤的情况下。应告知患者这种潜在并发症。
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