卡介苗免疫疗法治疗膀胱癌引发的牛分枝杆菌眼内炎
Mycobacterium bovis endophthalmitis from BCG immunotherapy for bladder cancer.
作者信息
Gerbrandy S J F, Schreuders L C, de Smet M D
机构信息
Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
Ocul Immunol Inflamm. 2008 May-Jun;16(3):95-7. doi: 10.1080/09273940802056273.
BACKGROUND
We report a patient who developed BCG endophthalmitis after BCG immunotherapy for bladder cancer. Comparison of this case with 2 other reported cases reveals a similar pattern of elderly, debilitated and immunocompromised patients with poor response to systemic antituberculous therapy in whom systemic steroids are used concurrently. Age and glucocorticoids are known to lead to thymic involution, reduce cell mediated immunity, and a lowering in the number of naive T cells capable of mounting an effective defense to new infectious agents.
CONCLUSIONS
Physicians should be aware of the potential for ocular complications of BCG immunotherapy in the elderly, immunocompromised, on oral steroids.
背景
我们报告了一名膀胱癌患者在接受卡介苗免疫治疗后发生了卡介苗性眼内炎。将该病例与其他2例报告病例进行比较，发现其模式相似，均为老年、体弱且免疫功能低下的患者，对全身抗结核治疗反应不佳，同时使用了全身类固醇。已知年龄和糖皮质激素会导致胸腺退化，降低细胞介导的免疫力，并减少能够对新感染因子进行有效防御的初始T细胞数量。
结论
医生应意识到老年、免疫功能低下且正在口服类固醇的患者接受卡介苗免疫治疗时发生眼部并发症的可能性。
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