Saraiva Vinicius S
Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, São Paulo, Brazil.
Retin Cases Brief Rep. 2015 Summer;9(3):195-7. doi: 10.1097/ICB.0000000000000136.
To describe a case of acute retinal necrosis and subsequent immune reconstitution inflammatory syndrome in a patient with multiple sclerosis treated with natalizumab.
Case report.
A 51-year-old man with multiple sclerosis developed acute retinal necrosis during treatment with natalizumab. The patient was successfully managed with natalizumab discontinuation, oral valacyclovir, and prophylactic laser retinal photocoagulation. A few months after natalizumab interruption and 1 month after valacyclovir completion, the patient presented with an episode of presumed noninfectious anterior and intermediate uveitis, which responded well to oral steroid mini-pulse therapy.
Natalizumab is a potent immune suppressor used in the treatment of multiple sclerosis and Crohn disease. It has already been linked to herpetic infections and immune reconstitution inflammatory syndrome in the central nervous system. These complications may also affect ocular tissues.
描述1例接受那他珠单抗治疗的多发性硬化患者发生急性视网膜坏死及随后的免疫重建炎症综合征的病例。
病例报告。
1例51岁的多发性硬化男性患者在接受那他珠单抗治疗期间发生急性视网膜坏死。通过停用那他珠单抗、口服伐昔洛韦及预防性视网膜激光光凝治疗，患者病情得到成功控制。在停用那他珠单抗数月后且伐昔洛韦治疗结束1个月后，患者出现1次疑似非感染性前葡萄膜炎和中间葡萄膜炎发作，口服类固醇小剂量脉冲疗法对其治疗效果良好。
那他珠单抗是一种用于治疗多发性硬化和克罗恩病的强效免疫抑制剂。它已与疱疹感染及中枢神经系统的免疫重建炎症综合征相关联。这些并发症也可能影响眼部组织。
