Artaechevarria Artieda June, Tapias Elias Ignacio
Department of Ophthalmology, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain.
Case Rep Ophthalmol. 2020 Jul 6;11(2):299-305. doi: 10.1159/000508237. eCollection 2020 May-Aug.
Idiopathic orbital inflammation (IOI) is a noninfectious inflammatory disease whose etiology remains unknown. Treatment is focused on reducing inflammation, which becomes challenging in nonresponding cases. We report the case of a 59-year-old woman with refractory IOI that showed a positive response to tocilizumab therapy. The patient was diagnosed with a unilateral sclerosing IOI for 9 years and showed a negative control with previous oral steroids, peribulbar steroid injections, radiotherapy, immunosuppressors, and intravenous rituximab. After the initiation of 8 mg/kg intravenous tocilizumab, a complete reduction of the pain and the orbital inflammation signs was observed and her condition remained stable for the following 6 years under a monthly dose of 4 mg/kg. In recalcitrant IOI cases, tocilizumab could be considered a possible treatment to reduce inflammatory signs and symptoms with positive long-term outcomes as in our case.
特发性眼眶炎症（IOI）是一种病因不明的非感染性炎症性疾病。治疗重点在于减轻炎症，而在无反应的病例中这颇具挑战性。我们报告了一例59岁患有难治性IOI的女性病例，该病例对托珠单抗治疗显示出阳性反应。该患者被诊断为单侧硬化性IOI达9年，之前使用口服类固醇、球周类固醇注射、放疗、免疫抑制剂及静脉注射利妥昔单抗均无效。在开始静脉注射8mg/kg托珠单抗后，疼痛和眼眶炎症体征完全缓解，并且在随后6年每月4mg/kg剂量的情况下病情保持稳定。在难治性IOI病例中，如我们的病例所示，托珠单抗可被视为一种可能减少炎症体征和症状并具有积极长期结果的治疗方法。
