用肿瘤坏死因子-α拮抗剂治疗难治性神经结节病中的视神经病变。
Optic neuropathy in refractory neurosarcoidosis treated with TNF-alpha antagonist.
作者信息
Salama Batoul, Gicquel Jean-Jacques, Lenoble Patrice, Dighiero Paul Louis
机构信息
Fédération Inter-Hospitalière Pico-Charentaise d'Opthalmologie, Poitiers University Hospital, France.
出版信息
Can J Ophthalmol. 2006 Dec;41(6):766-8. doi: 10.1139/i06-074.
CASE REPORT
To report a rare case of optic neuropathy in refractory neurosarcoidosis treated with tumour necrosis factor-alpha antagonist (infliximab) perfusion. A 41-year-old man with diabetes presented with an abrupt, painless, unilateral visual loss. Thoracic computed tomography disclosed mediastinal lymphadenopathy, and evidence from histopathology confirmed sarcoidosis.
COMMENTS
Corticosteroids alone and with immunosuppressive agents failed to suppress the active disease. Alternative therapy of infliximab perfusions resulted in disease remission and relative visual improvement, and this treatment may warrant further clinical studies.
病例报告
报告一例难治性神经结节病采用肿瘤坏死因子-α拮抗剂（英夫利昔单抗）灌注治疗导致视神经病变的罕见病例。一名41岁糖尿病男性患者出现突发、无痛性单眼视力丧失。胸部计算机断层扫描显示纵隔淋巴结肿大，组织病理学证据证实为结节病。
评论
单独使用皮质类固醇以及联合免疫抑制剂均未能抑制疾病活动。英夫利昔单抗灌注的替代疗法使疾病缓解且视力相对改善，这种治疗方法可能值得进一步开展临床研究。
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