造血干细胞移植后脂肪营养不良患者糖尿病视网膜病变加速进展。
ACCELERATED PROGRESSION OF DIABETIC RETINOPATHY IN A PATIENT WITH ACQUIRED LIPODYSTROPHY AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION.
机构信息
Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan.
出版信息
Retin Cases Brief Rep. 2023 May 1;17(3):321-323. doi: 10.1097/ICB.0000000000001180.
PURPOSE
To report a case of bilateral proliferative diabetic retinopathy and lipemia retinalis in a patient with acquired lipodystrophy.
METHODS
A retrospective case report.
RESULTS
A 23-year-old woman with a diagnosis of acquired lipodystrophy was referred for ophthalmic evaluation. She had been diagnosed with acute lymphocytic leukemia at the age of 3 years and undergone hematopoietic stem cell transplantation. Best-corrected visual acuity was 20/20 in both eyes; however, funduscopy revealed bilateral diabetic retinopathy and lipemia retinalis, neither of which was apparent 2 years earlier. She had a glycated hemoglobin level of 9.6% and a triglyceride level of 7,394 mg/dL with creamy appearance of serum. Fluorescein angiography showed bilateral neovascularization.
CONCLUSION
Accelerated progression of diabetic retinopathy in this case seemed to be associated with the onset of lipemia retinalis. We encourage continued ophthalmologic monitoring of patients who underwent hematopoietic stem cell transplantation in childhood for possible accelerated course of diabetic retinopathy.
目的
报告 1 例获得性脂肪营养不良患者合并双侧增殖性糖尿病视网膜病变和脂血症性视网膜病变。
方法
回顾性病例报告。
结果
1 名 23 岁女性因获得性脂肪营养不良就诊，眼科评估。她在 3 岁时被诊断为急性淋巴细胞白血病，并接受了造血干细胞移植。双眼最佳矫正视力均为 20/20；然而，眼底检查显示双侧糖尿病视网膜病变和脂血症性视网膜病变，而 2 年前眼底均未见异常。糖化血红蛋白水平为 9.6%，三酰甘油水平为 7394mg/dL，血清呈奶油状外观。荧光素血管造影显示双侧新生血管形成。
结论
本例糖尿病视网膜病变的加速进展似乎与脂血症性视网膜病变的发生有关。我们鼓励对儿童期接受造血干细胞移植的患者进行持续的眼科监测，以观察可能加速的糖尿病视网膜病变病程。
Zotero 插件