一名接受全身性免疫抑制（他克莫司）治疗的患者，其结膜鳞状乳头瘤对干扰素α-2b治疗无效。
Conjunctival squamous papilloma refractory to interferon α-2b in a patient on systemic immunosuppression (tacrolimus).
作者信息
Ganapathy Preethi S, Plesec Thomas, Singh Arun D
机构信息
Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
Pathology Institute, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Am J Ophthalmol Case Rep. 2017 Feb 3;6:1-3. doi: 10.1016/j.ajoc.2017.01.005. eCollection 2017 Jun.
PURPOSE
To describe a case of diffuse conjunctival papilloma in an immunocompromised individual on tacrolimus that was refractory to treatment with interferon α-2b, but responded to topical mitomycin-c.
OBSERVATIONS
A 79-year-old Caucasian female with a history of a liver transplant twenty years ago, who was immunosuppressed with tacrolimus (2 mg daily) presented with a diffuse conjunctival and corneal squamous papilloma. Following treatment with four weekly subconjunctival interferon-α2b injections (3 million units/0.5 mL) and 3 months of topical interferon-α2b therapy (1 million units/mL), four times daily, slow progression was documented. The patient was switched to topical mitomycin-c drops (0.04%) administered four times daily (one week on and one week off) with dramatic regression of the tumor.
CONCLUSIONS AND IMPORTANCE
In cases of conjunctival squamous papilloma that do not respond readily to topical interferon, topical mitomycin-c is an alternate therapeutic option. We hypothesize that use of tacrolimus may have contributed to the lack of response to topical interferon-α2b.
目的
描述一例免疫功能低下的个体在使用他克莫司时发生的弥漫性结膜乳头状瘤，该肿瘤对干扰素α-2b治疗无效，但对局部应用丝裂霉素C有反应。
观察结果
一名79岁的白种女性，20年前有肝移植病史，正在接受他克莫司（每日2毫克）免疫抑制治疗，出现弥漫性结膜和角膜鳞状乳头状瘤。在每周结膜下注射四次干扰素-α2b（300万单位/0.5毫升）并局部应用干扰素-α2b治疗3个月（100万单位/毫升，每日四次）后，记录到肿瘤进展缓慢。患者改用局部应用丝裂霉素C滴眼液（0.04%），每日四次（用药一周，停药一周），肿瘤显著消退。
结论及重要性
对于局部应用干扰素反应不佳的结膜鳞状乳头状瘤病例，局部应用丝裂霉素C是一种替代治疗选择。我们推测使用他克莫司可能导致了对局部应用干扰素-α2b缺乏反应。
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