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神经视网膜炎:POEMS 综合征中的一种罕见合并感染。

Neuroretinitis: A Rare Coinfection in POEMS Syndrome.

机构信息

University Sains Malaysia School of Medical Sciences, Department of Ophthalmology, Kelantan, Malaysia.

University Sains Malaysia Hospital USM, Kelantan, Malaysia.

出版信息

Turk J Ophthalmol. 2020 Dec 29;50(6):371-376. doi: 10.4274/tjo.galenos.2020.83873.

Abstract

is a recognized cause of neuroretinitis in cat scratch disease. Meanwhile, polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome with Castleman disease (evidence of lymph node hyperplasia), is a chronic debilitating condition that predisposes to various superimposed infections. neuroretinitis implicated in POEMS syndrome has not been reported previously. A 34-year-old asymptomatic man was referred for an eye assessment. Examination showed visual acuity of 6/18 in the right eye and 6/24 in the left eye. On fundus examination, both eyes exhibited typical features of neuroretinitis (optic disc swelling and incomplete macular star). There was otherwise no vitritis or chorioretinitis. Serology for revealed high immunoglobulin M (IgM) titer (1:96) indicative of acute disease, and positive immunoglobulin G (IgG) (1:156). He was treated with oral azithromycin for 6 weeks and a short course of oral prednisolone. Subsequently, the visual acuity in both eyes improved with resolution of macular star. However, both optic discs remained swollen.

摘要

弓形虫感染是猫抓病性神经视网膜炎的公认病因。同时,POEMS 综合征伴发的多发性神经病、器官肿大、内分泌病、单克隆丙种球蛋白病、皮肤改变(POEMS)和伴发的Castleman 病(淋巴结增生的证据)是一种慢性消耗性疾病,易发生各种重叠感染。以前没有报道过与 POEMS 综合征有关的神经视网膜炎。一名 34 岁无症状男性被转来进行眼部评估。检查显示右眼视力为 6/18,左眼视力为 6/24。眼底检查显示双眼均有典型的神经视网膜炎特征(视盘肿胀和不完全性黄斑星)。此外,没有葡萄膜炎或脉络膜炎。弓形虫血清学检查显示高免疫球蛋白 M(IgM)滴度(1:96)提示急性疾病,且免疫球蛋白 G(IgG)阳性(1:156)。他接受了 6 周的口服阿奇霉素和短期口服泼尼松龙治疗。随后,双眼视力均有所提高,黄斑星消退。然而,两个视盘仍肿胀。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73c0/7802104/752b6b6cb1d9/TJO-50-371-g1.jpg

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