免疫抑制治疗威胁视力的葡萄膜炎期间的脓毒症：另一面。
Sepsis During Immunosuppression for Sight-threatening Uveitis: The Flip side.
机构信息
a Manchester Royal Eye Hospital , Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK; Medical Academic Health Science Centre, University of Manchester , Manchester , UK.
出版信息
Ocul Immunol Inflamm. 2018;26(2):324-327. doi: 10.1080/09273948.2016.1205633. Epub 2016 Aug 19.
PURPOSE
To highlight the rare but life-threatening infective consequences of immunosuppression or biologic treatment for sight-threatening uveitis.
PATIENTS AND METHODS
Retrospective case series of four immunosuppressed patients with uveitis complicated by sepsis.
RESULTS
The affected patients were all treated using prednisolone 10 mg/day or greater, together with oral immunosuppression (2 mycophenolate mofetil, 1 azathioprine + ciclosporin, 1 methotrexate) and, in one case, infliximab. All patients survived following intensive treatment.
CONCLUSION
Life-threatening infection is a rare but important risk in immunosuppressed patients with uveitis. Complete protection is not possible and prophylaxis regimens are of unproven efficacy. Patients should understand the risks before agreeing to a course of treatment.
目的
强调免疫抑制或生物治疗对视威胁性葡萄膜炎的罕见但危及生命的感染后果。
患者和方法
回顾性病例系列研究，纳入 4 例因葡萄膜炎合并败血症而接受免疫抑制治疗的患者。
结果
受影响的患者均接受泼尼松龙 10mg/天或更大剂量治疗，同时接受口服免疫抑制治疗（2 例霉酚酸酯，1 例硫唑嘌呤+环孢素，1 例甲氨蝶呤），其中 1 例还接受英夫利昔单抗治疗。所有患者经强化治疗后均存活。
结论
危及生命的感染是免疫抑制的葡萄膜炎患者的一种罕见但重要的风险。完全预防是不可能的，预防方案的疗效也未经证实。在开始治疗前，患者应了解相关风险。
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