接受阿达木单抗治疗的克罗恩病患者出现无症状脉络膜结节。
Asymptomatic choroidal tubercle in a patient with Crohn's disease on adalimumab treatment.
作者信息
Asensio-Sánchez V M, Díaz-Cabanas L, Martín-Prieto A, Haro-Álvarez B
机构信息
Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, España.
Servicio de Oftalmología, Hospital Clínico Universitario, Valladolid, España.
出版信息
Arch Soc Esp Oftalmol (Engl Ed). 2018 Mar;93(3):147-150. doi: 10.1016/j.oftal.2017.06.009. Epub 2017 Jul 22.
INTRODUCTION
Adalimumab, an anti-tumour necrosis factor alpha therapy for active Crohn's disease (CD), is associated with increased risks of tuberculosis infection.
CASE REPORT
The case is presented of a 48 year-old male with active CD on treatment with adalimumab. After three months, he developed a miliary pulmonary tuberculosis infection, with a solitary non-reactive choroidal tubercle temporal-superior to the optic disc being found in an ophthalmological study. Fluorescein angiography showed late hyperfluorescence in a staining pattern. Optic coherence tomography showed a flat mass without serous retinal detachment. The choroidal tubercle slowly regressed with antituberculosis therapy.
DISCUSSION
Choroidal tubercles with no vitreo-retinal symptomatology can be present in patients with CD and on treatment with adalimumab.
引言
阿达木单抗是一种用于治疗活动性克罗恩病（CD）的抗肿瘤坏死因子α疗法，与结核感染风险增加相关。
病例报告
报告一例48岁男性活动性CD患者，正在接受阿达木单抗治疗。三个月后，他发生了粟粒性肺结核感染，眼科检查发现视盘颞上方有一个孤立的无反应性脉络膜结核结节。荧光素血管造影显示晚期高荧光染色模式。光学相干断层扫描显示扁平肿块，无浆液性视网膜脱离。经抗结核治疗后，脉络膜结核结节缓慢消退。
讨论
患有CD并接受阿达木单抗治疗的患者可能出现无玻璃体视网膜症状的脉络膜结核结节。
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