Ocul Immunol Inflamm. 2012 Feb;20(1):44-8. doi: 10.3109/09273948.2011.623212. Epub 2011 Oct 21.
To describe a case of sarcoid uveitis subsequent to anti-TNFα therapy and review previously reported cases.
Review of the clinical records of the authors' patient and of the literature using the PubMed database.
A 30-year-old woman presented with intermediate uveitis with snowballs in both eyes. She was on treatment with etanercept due to psoriatic arthritis. An ultrasound-guided biopsy of a mediastinal adenopathy showed non-necrotizing granulomas compatible with sarcoidosis. The clinical picture resolved after etanercept was withdrawn and treatment with immunosuppressants. In a literature search the authors identified six other cases of sarcoid uveitis induced by anti-TNFα therapy. The types of uveitis were anterior uveitis, posterior uveitis, or panuveitis. Management consisted of withdrawal of anti-TNFα therapy and administration of immunosuppressive agents in 5 cases.
Sarcoid uveitis induced by TNFα antagonists is a rare complication. Appropriate management consists of withdrawing the TNFα antagonist and giving immunosuppressants.
描述一例抗 TNFα 治疗后继发的肉样瘤性葡萄膜炎，并复习以往报道的病例。
回顾作者患者的临床记录和使用 PubMed 数据库的文献。
一名 30 岁女性因患有银屑病关节炎而接受依那西普治疗，出现双眼中间葡萄膜炎伴雪球样混浊。超声引导下纵隔淋巴结活检显示非坏死性肉芽肿，符合结节病。停用依那西普并接受免疫抑制剂治疗后，临床症状缓解。在文献检索中，作者共发现另外 6 例由抗 TNFα 治疗引起的肉样瘤性葡萄膜炎。葡萄膜炎的类型为前葡萄膜炎、后葡萄膜炎或全葡萄膜炎。5 例患者接受了抗 TNFα 治疗药物的撤药和免疫抑制剂治疗。
TNFα 拮抗剂诱导的肉样瘤性葡萄膜炎是一种罕见的并发症。适当的治疗方法是撤掉 TNFα 拮抗剂并给予免疫抑制剂。
