英夫利昔单抗诱导的脱髓鞘导致视功能障碍，误诊为 HLA-B27 相关葡萄膜炎复发。
Infliximab-induced demyelination causes visual disturbance mistaken for recurrence of HLA-B27-related uveitis.
机构信息
Centre for Specialized Ophthalmic Care (COS), Lausanne, Switzerland.
出版信息
Ocul Immunol Inflamm. 2010 Dec;18(6):482-4. doi: 10.3109/09273948.2010.496914. Epub 2010 Aug 25.
PURPOSE
To report a patient treated with infliximab for ankylosing spondylitis and HLA-B27 uveitis presenting with a scotoma in his left good eye due to infliximab-induced occipital demyelination mistaken for a uveitis recurrence.
DESIGN
Case report.
METHODS
Review of clinical features, visual field, and investigational procedures.
RESULTS
Loss of visual function could not be explained by mere ophthalmic examination. Magnetic resonance imaging showed several demyelinating lesions, explaining the patient's symptoms and signs. Infiliximab was discontinued and the scotoma disappeared.
CONCLUSION
This is the first report of infliximab-induced demyelination producing ocular symptoms and signs in a patient treated for uveitis.
目的
报告 1 例接受英夫利昔单抗治疗强直性脊柱炎和 HLA-B27 葡萄膜炎的患者，因英夫利昔单抗诱导的枕叶脱髓鞘而出现左眼弱视性暗点，误诊为葡萄膜炎复发。
设计
病例报告。
方法
回顾临床特征、视野和检查程序。
结果
单纯眼科检查无法解释视力丧失。磁共振成像显示有几个脱髓鞘病变，解释了患者的症状和体征。停用英夫利昔单抗后，暗点消失。
结论
这是首例英夫利昔单抗诱导的脱髓鞘导致接受葡萄膜炎治疗的患者出现眼部症状和体征的报告。
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