一名接受免疫抑制治疗的系统性红斑狼疮血清阴性患者发生巨细胞病毒性视网膜炎。
Cytomegalovirus retinitis in a seronegative patient with systemic lupus erythematosus on immunosuppressive therapy.
作者信息
Kelkar Aditya, Kelkar Jai, Kelkar Shreekant, Bhirud Shilpa, Biswas Jyotirmoy
机构信息
National Institute of Ophthalmology, 1187/30 off Ghole Road, Shivajinagar, Pune, 411005, Maharashtra, India,
出版信息
J Ophthalmic Inflamm Infect. 2011 Sep;1(3):129-32. doi: 10.1007/s12348-010-0017-3. Epub 2011 Apr 3.
AIM
The purpose of this study is to report a rare case of cytomegalovirus (CMV) retinitis in a seronegative patient with systemic lupus erythematosus (SLE) on immunosuppressive therapy.
METHODS
A seronegative patient with SLE who was on immunosuppressive therapy developed CMV retinitis. The immunosuppressive therapy was tapered, and the patient was given intravitreal ganciclovir and foscarnet in addition to systemic ganciclovir. The follow-up visits were documented.
RESULT
The patient responded to the treatment and there was complete resolution.
CONCLUSION
CMV retinitis is a rapidly progressive condition and patients on immunosuppressive therapy should be referred to an ophthalmologist for periodic check-up for early diagnosis and treatment of this devastating ophthalmic condition. For clinically resistant CMV retinitis in seronegative patients with SLE, a combination therapy of intravitreal foscarnet with oral and intravenous ganciclovir is useful.
目的
本研究旨在报告一例血清学阴性的系统性红斑狼疮（SLE）患者在接受免疫抑制治疗时发生巨细胞病毒（CMV）视网膜炎的罕见病例。
方法
一名接受免疫抑制治疗的血清学阴性SLE患者发生了CMV视网膜炎。逐渐减少免疫抑制治疗剂量，并给予患者玻璃体内更昔洛韦和膦甲酸钠，同时给予全身用更昔洛韦。记录随访情况。
结果
患者对治疗有反应，病变完全消退。
结论
CMV视网膜炎是一种进展迅速的疾病，接受免疫抑制治疗的患者应转诊至眼科医生处进行定期检查，以便早期诊断和治疗这种严重的眼科疾病。对于血清学阴性的SLE患者中临床上耐药的CMV视网膜炎，玻璃体内膦甲酸钠联合口服及静脉用更昔洛韦的联合治疗是有效的。
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