Herrera Isabella, Kam Yong, Whittaker Thomas J, Champion Mary, Ajlan Radwan S
Department of Ophthalmology, University of Kansas School of Medicine, 7400 State Line Rd, Prairie Village, Kansas, USA.
BMC Ophthalmol. 2019 Feb 14;19(1):51. doi: 10.1186/s12886-019-1063-8.
To report a case of orbital inflammation after bisphosphonate infusion in a patient who was already receiving immunosuppressive therapy.
A 56-year-old woman presented to the ophthalmology clinic with acute onset of right eye pain 24 h after receiving her first Zolendronic acid infusion. She has a past medical history of chronic inflammatory demyelinating polyneuropathy, Sjogren's syndrome, and systemic lupus erythematosus that have been controlled with immunosuppressive therapy for three years. Clinical ophthalmic exam and MRI studies were significant for right orbital inflammation. The patient was started on oral prednisone with rapid resolution of symptoms.
This is the first case report of a patient receiving chronic immunosuppressive therapy to develop orbital inflammation after Zoledronic acid infusion. In addition, it demonstrates that corticosteroids can be an effective first line therapy in treating orbital inflammation in similar patients. Physicians should be aware of this rare but serious potential side effect of bisphosphonates, and have bisphosphonate-related orbital inflammation on their differential for proper initiation of treatment.
报告1例在已接受免疫抑制治疗的患者中，双膦酸盐输注后出现眼眶炎症的病例。
一名56岁女性在接受首次唑来膦酸输注24小时后，因右眼急性疼痛就诊于眼科门诊。她有慢性炎症性脱髓鞘性多发性神经病、干燥综合征和系统性红斑狼疮病史，已接受免疫抑制治疗三年。临床眼科检查和MRI研究显示右眼眼眶炎症明显。患者开始口服泼尼松，症状迅速缓解。
这是首例接受慢性免疫抑制治疗的患者在唑来膦酸输注后发生眼眶炎症的病例报告。此外，它表明皮质类固醇可作为治疗类似患者眼眶炎症的有效一线治疗方法。医生应意识到双膦酸盐这种罕见但严重的潜在副作用，并在鉴别诊断中考虑双膦酸盐相关的眼眶炎症，以便正确启动治疗。
