一例多发性硬化症患者在未停用芬戈莫德的情况下黄斑水肿得到改善：病例报告
Improvement of macular edema without discontinuation of fingolimod in a patient with multiple sclerosis: A case report.
作者信息
Akiyama Hisanao, Suzuki Yu, Hara Daisuke, Shinohara Kensuke, Ogura Hana, Akamatsu Masashi, Hasegawa Yasuhiro
机构信息
Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
出版信息
Medicine (Baltimore). 2016 Jul;95(29):e4180. doi: 10.1097/MD.0000000000004180.
INTRODUCTION
Generally, fingolimod administration is simply discontinued when fingolimod-associated macular edema (ME) appears, and the majority of cases are said to recover spontaneously. However, to the best of our knowledge, this is the 1st report regarding improvement of ME without discontinuation of fingolimod administration.
CASE PRESENTATION
The patient was a 66-year-old woman with relapsing-remitting multiple sclerosis. She was started on treatment with fingolimod to prevent recurrence, after which she developed ME that was probably due to fingolimod. The patient expressed a strong fear of recurrence if fingolimod was discontinued, so we continued fingolimod therapy and followed up the patient frequently. The ME improved after approximately 1 year without any need for concomitant treatment.
CONCLUSION
We believe that the continuation of fingolimod therapy with strict follow-up examination is one option for treatment, though strategies for managing rapid deterioration of ME should be borne in mind.
引言
一般来说，当出现与芬戈莫德相关的黄斑水肿（ME）时，通常会简单地停用芬戈莫德，据说大多数病例会自发恢复。然而，据我们所知，这是第一份关于在不停用芬戈莫德的情况下ME得到改善的报告。
病例介绍
该患者是一名66岁的复发缓解型多发性硬化症女性。她开始接受芬戈莫德治疗以预防复发，之后出现了可能由芬戈莫德引起的ME。患者表示如果停用芬戈莫德，非常担心疾病复发，所以我们继续进行芬戈莫德治疗，并对患者进行频繁随访。大约1年后，ME得到改善，无需任何伴随治疗。
结论
我们认为，在严格的随访检查下继续芬戈莫德治疗是一种治疗选择，不过应牢记应对ME快速恶化的策略。
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