Safo Myra B, Silkiss Rona Z
Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA.
Am J Ophthalmol Case Rep. 2021 Mar 10;22:101069. doi: 10.1016/j.ajoc.2021.101069. eCollection 2021 Jun.
To present a case of ulcerative colitis associated with teprotumumab treatment for thyroid eye disease.
A 46-year-old Indian female was treated with teprotumumab (Tepezza) for severe thyroid eye disease within 9 months of diagnosis. The patient noted progression of her disease on oral prednisone and demonstrated severe, debilitating proptosis accompanied by eye ache and dry eyes. After 5 infusions of teprotumumab over a four-month period, the patient developed bloody diarrhea and fecal urgency. These symptoms progressively worsened and after two additional treatments, she underwent a colonoscopy. This confirmed the diagnosis of ulcerative colitis (UC). Treatment with teprotumumab was halted prior to the administration of the 8th infusion; however, the patient continued to have severe gastrointestinal symptoms two months after her last treatment.
Teprotumumab is an insulin-like growth factor-1 receptor (IGF-1R) inhibitor demonstrated to improve proptosis in patients with active thyroid eye disease. Most adverse events reported are mild or moderate in severity; however, inflammatory bowel disease (IBD) is a serious adverse event that can develop as a result of treatment.
报告一例与替普罗单抗治疗甲状腺眼病相关的溃疡性结肠炎病例。
一名46岁的印度女性在诊断后9个月内接受替普罗单抗（Tepezza）治疗严重甲状腺眼病。患者在口服泼尼松治疗期间病情进展，出现严重的、使人衰弱的眼球突出，并伴有眼痛和干眼。在四个月内进行了5次替普罗单抗输注后，患者出现血便和便急。这些症状逐渐加重，在另外两次治疗后，她接受了结肠镜检查。这证实了溃疡性结肠炎（UC）的诊断。在第8次输注前停止了替普罗单抗治疗；然而，在最后一次治疗两个月后，患者仍有严重的胃肠道症状。
替普罗单抗是一种胰岛素样生长因子-1受体（IGF-1R）抑制剂，已证明可改善活动性甲状腺眼病患者的眼球突出。报告的大多数不良事件严重程度为轻度或中度；然而，炎症性肠病（IBD）是一种可能因治疗而发生的严重不良事件。
