Nascimento Heloisa, Sousa Jacqueline M, Fernández Délia González, Salomão Gustavo H A, Sato Elcio H, Muccioli Cristina, Belfort Rubens
Ophthalmic Surg Lasers Imaging Retina. 2018 Jan 1;49(1):70-75. doi: 10.3928/23258160-20171215-12.
In a prospective case series of patients with Blau-Jabs syndrome (BJS) conducted in the Ophthalmology Department/Federal University of Sao Paulo, seven patients with clinical and ophthalmologic manifestations of the disease and a positive genetic test result for the presence of a mutation in the CARD15/NOD2 gene were followed for a minimal period of 1 year. All patients had uveitis, five had nummular corneal subepithelial opacities, and four had multifocal choroiditis. Oral prednisolone was administered to all patients; inflammation was controlled in six patients with at least one immunosuppressive drug. Infliximab (Remicade; Janssen Pharmaceuticals, Beerse, Belgium) and etanercept (Enbrel; Amgen, Thousand Oaks, CA) were used to treat two cases refractory to the anti-inflammatory drugs. A subconjunctival dexamethasone implant (Ozurdex; Allergan, Irvine, CA) and a periocular injection of triamcinolone were used in one case to achieve inflammation control. Six patients achieved a visual acuity of 20/25 or better. The authors conclude that periocular treatment with steroid injections might be effective adjuvant therapy to control ocular inflammation. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:70-75.].
在圣保罗联邦大学眼科开展的一项关于布劳-雅布斯综合征(BJS)患者的前瞻性病例系列研究中,对7例具有该疾病临床和眼科表现且CARD15/NOD2基因突变检测结果呈阳性的患者进行了至少1年的随访。所有患者均患有葡萄膜炎,5例有钱币状角膜上皮下混浊,4例有多灶性脉络膜炎。所有患者均接受口服泼尼松龙治疗;6例患者使用至少一种免疫抑制药物后炎症得到控制。英夫利昔单抗(类克;杨森制药公司,比利时贝尔瑟)和依那西普(恩利;安进公司,加利福尼亚州千橡市)用于治疗2例对抗炎药物难治的病例。1例患者使用结膜下注射地塞米松植入剂(奥瑞珠;艾尔建公司,加利福尼亚州欧文市)和眼周注射曲安奈德来控制炎症。6例患者视力达到20/25或更好。作者得出结论,眼周注射类固醇治疗可能是控制眼部炎症的有效辅助治疗方法。[《眼科手术、激光与影像学视网膜》。2018年;49:70 - 75。]