爱泼斯坦-巴尔病毒引起的移植后淋巴细胞增生性疾病伴单侧视网膜受累。
Epstein-Barr virus induced post-transplant lymphoproliferative disorder presenting with unilateral retinal involvement.
作者信息
Adam Mainguy, Elise Philippakis, Sutra Del Galy Aurélien, Dinu Stanescu-Segall, Ramin Tadayoni, Bahram Bodaghi, Sophie Bonnin, Sara Touhami
机构信息
Department of Ophthalmology, Centre Hospitalo-Universitaire de Nantes, Université de Nantes, France.
Department of Ophthalmology, Reference Center in Rare Diseases, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France.
出版信息
Am J Ophthalmol Case Rep. 2021 Aug 2;23:101186. doi: 10.1016/j.ajoc.2021.101186. eCollection 2021 Sep.
PURPOSE
Post-transplant lymphoproliferative disorder (PTLD) represents a spectrum of disorders associated with Epstein Barr Virus infection in up to 80% of cases in the setting of pharmacologic immunosuppression following hematopoietic stem cell or solid organ transplantation. Ocular involvement is a rare finding in PTLD.
OBSERVATION
We report the case of a 38-year-old man who presented with unilateral retinal infiltrates as first manifestation of PTLD relapse. Diagnosis relied on the presence of EBV DNA in anterior chamber fluids and vitrectomy that showed the presence of a B cell clone. Systemic relapse of PTLD was detected 12 weeks after retinal findings. Treatment of ocular disease included systemic injections of rituximab and intravitreal injections of methotrexate, halting the extension of retinal infiltrates.
CONCLUSION
Ocular involvement in PTLD is rare and needs to be acknowledged because it can precede a systemic relapse of the hematological condition.
目的
移植后淋巴细胞增生性疾病（PTLD）是一系列与爱泼斯坦-巴尔病毒感染相关的疾病，在造血干细胞或实体器官移植后接受药物免疫抑制的情况下，高达80%的病例与之相关。眼部受累在PTLD中是一种罕见的表现。
观察
我们报告了一例38岁男性病例，其以单侧视网膜浸润作为PTLD复发的首发表现。诊断依赖于前房液中EBV DNA的存在以及玻璃体切除显示存在B细胞克隆。视网膜病变出现12周后检测到PTLD的全身复发。眼部疾病的治疗包括全身注射利妥昔单抗和玻璃体内注射甲氨蝶呤，阻止了视网膜浸润的扩展。
结论
PTLD的眼部受累罕见，需要引起重视，因为它可能先于血液系统疾病的全身复发出现。
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