Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease.
Bilateral herpes simplex keratitis in a patient with chronic graft-versus-host disease.
复制标题
DOI：
10.2147/opth.s1858
复制
发表时间：
2008-06
期刊：
影响因子：
--
通讯作者：
Mizuki N
中科院分区：
文献类型：
--
作者：
Hayashi T;Ishioka M;Ito N;Kato Y;Nakagawa H;Hatano H;Mizuki N
描述一例合并慢性移植物抗宿主病(GVHD)的双侧单纯疱疹病毒性角膜炎。观察性病例报告。一名11岁的男孩患有粒细胞白血病，接受了异基因骨髓移植。他出现了皮肤、眼睛和口腔的症状，嘴唇活检表明是慢性移植物抗宿主病。双眼均观察到持续性角膜炎伴角膜细丝和新生血管形成。透明质酸钠、自体血清和0.1%的氟米松滴眼液滴入治疗这种角膜炎大约2年，没有其他眼部改变。局部应用倍他米松治疗后，双侧单纯疱疹病毒性角膜炎出现局部溃疡，但对阿昔洛韦软膏有反应。在免疫功能低下患者的双侧角膜炎的鉴别诊断中应考虑疱疹角膜炎。在慢性GVHD过程中，可能会发生角膜疱疹，因此眼科医生应该使用局部皮质类固醇进行眼科治疗，以监测威胁视力的情况，如角膜疱疹。
To describe a case of bilateral herpes simplex keratitis accompanying chronic graft-versus-host disease (GVHD). Observational case report. An 11-year-old boy with myelocytic leukemia underwent allogeneic bone marrow transplantation. He developed symptoms of the skin, eyes, and mouth, and lip biopsy indicated chronic GVHD. Persistent keratitis with corneal filaments and neovascularization was noted in both eyes. Sodium hyaluronate, autoserum, and 0.1% fluorometholone eyedrops were instilled for approximately 2 years to treat this keratitis, and there were no other ocular changes. Bilateral herpes simplex keratitis developed with geographic ulcers after topical betamethasone therapy, but responded to acyclovir ointment. Herpes keratitis should be considered in the differential diagnosis of bilateral keratitis in patients with reduced immunocompetence. During the course of chronic GVHD, corneal herpes may occur, so ocular treatment with topical corticosteroids should be managed by an ophthalmologist to monitor sight-threatening conditions such as corneal herpes.