Fujimoto Kaori, Hiraoka Miki, Inatomi Shuichiro, Ohguro Hiroshi
Department of Ophthalmology, School of Medicine, Sapporo Medical University, Sapporo, Japan.
Case Rep Ophthalmol. 2014 Nov 13;5(3):365-72. doi: 10.1159/000369125. eCollection 2014 Sep.
Two female patients with histories of cancer who showed cryptogenic organizing pneumonia (COP) complications and bilateral anterior uveitis with hypopyon were examined. Both patients had suffered from COP and received intermitted systemic corticosteroid administration (SCA). The first patient, a 65-year-old woman with a history of breast cancer, showed bilateral uveitis with hypopyon. The topical corticosteroid treatment was ineffective. After SCA for the treatment of COP was started, the hypopyon gradually dissipated. Upon termination of SCA, uveitis relapses were controlled by renewed SCA. The other patient, a 69-year-old woman with a history of ovarian cancer, showed bilateral anterior uveitis with hypopyon. Her intraocular outcome did not improve by the topical corticosteroid administration, but SCA that was applied to treat COP led to remission of uveitis. Imaging examinations, biochemical analysis, symptoms or HLA-B27 antigen screenings in either patient did not explain the development of uveitis. Bilateral anterior uveitis is commonly related to autoimmune disease or systemic syndrome. We report two cases with COP that developed bilateral anterior uveitis with hypopyon resistant to topical administration but responsive to systemic administration of corticosteroid. These findings suggest that COP can be associated with the etiology of anterior uveitis.
对两名有癌症病史且出现隐源性机化性肺炎(COP)并发症以及双侧前葡萄膜炎伴前房积脓的女性患者进行了检查。两名患者均患有COP,并接受了间歇性全身糖皮质激素给药(SCA)。第一名患者是一位65岁有乳腺癌病史的女性,表现为双侧葡萄膜炎伴前房积脓。局部糖皮质激素治疗无效。在开始使用SCA治疗COP后,前房积脓逐渐消散。SCA终止后,葡萄膜炎复发通过重新开始SCA得到控制。另一名患者是一位69岁有卵巢癌病史的女性,表现为双侧前葡萄膜炎伴前房积脓。局部应用糖皮质激素后其眼内情况并未改善,但用于治疗COP的SCA导致葡萄膜炎缓解。两名患者的影像学检查、生化分析、症状或HLA - B27抗原筛查均无法解释葡萄膜炎的发生。双侧前葡萄膜炎通常与自身免疫性疾病或全身综合征有关。我们报告了两例COP患者,其出现双侧前葡萄膜炎伴前房积脓,对局部给药耐药但对全身应用糖皮质激素有反应。这些发现提示COP可能与前葡萄膜炎的病因有关。