Bilateral Cytomegalovirus Retinitis in a Patient with Systemic Lupus Erythematosus
Bilateral Cytomegalovirus Retinitis in a Patient with Systemic Lupus Erythematosus
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DOI：
10.1159/000446391
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发表时间：
2016-05-01
影响因子：
0.4
通讯作者：
Ikeda, Tsunehiko
中科院分区：
文献类型：
--
作者：
Haze, Masaya;Kobayashi, Takatoshi;Ikeda, Tsunehiko
目的：本研究的目的是报告一位因巨细胞病毒（CMV）视网膜炎引起的双侧孔源性视网膜脱离而接受玻璃体切除术的患者，同时接受类固醇和免疫抑制剂治疗系统性红斑狼疮（SLE）。病例报告：我们报告一位29岁女性，在日本高月市大坂医学院医院接受类固醇及免疫抑制剂治疗系统性红斑狼疮。由于腹泻延长和恶化，对患者进行检查，结果显示C7-HRP检测结果阳性，并诊断为CMV结肠炎。她随后入院，开始静脉注射更昔洛韦治疗。大约1.5个月后，她的主诉是左眼上视野恶化，随后被转诊至眼科。在她左眼的视网膜下部区域周围发现许多颗粒状渗出点，视网膜坏死区域出现视网膜裂孔，导致视网膜脱离。经过一段时间后，患者的一般状况得到改善，对该眼进行了玻璃体切除术。患者随后右眼出现类似的视网膜脱离，为此进行了玻璃体切除术。虽然患者双眼需要多次手术，但她的视网膜目前仍保持复位，炎症也已消退。结论：本研究的结果表明，由于CMV视网膜炎可能与SLE患者的免疫抑制治疗有关，因此必须给予严格的关注。(C)2016作者（s）由S. Karger AG，巴塞尔
Purpose: The purpose of this study was to report the case of a patient who underwent vitrectomy for bilateral rhegmatogenous retinal detachment caused by cytomegalovirus (CMV) retinitis while undergoing steroid and immunosuppressant therapy for systemic lupus erythematosus (SLE). Case Report: We report on a 29-year-old female who was undergoing steroids and immunosuppressants treatment for SLE at Osaka Medical College Hospital, Takatsuki City, Japan. Examination of the patient due to prolonged and worsening diarrhea revealed positive test results for C7-HRP, and she was diagnosed with CMV colitis. She was subsequently admitted to the hospital and started on intravenous ganciclovir for treatment. Approximately 1.5 months later, her primary complaint was deterioration of the upper visual field in her left eye, and she was then referred to the Department of Ophthalmology. Numerous granular exudative spots were found around the lower retinal area of her left eye with retinal breaks that had developed in an area of retinal necrosis that resulted in retinal detachment. After time was allowed for the patient's general condition to improve, a vitrectomy was performed on that eye. The patient subsequently developed a similar retinal detachment in her right eye, for which she underwent a vitrectomy. Although the patient required multiple surgeries on both eyes, her retinas currently remain reattached and the inflammation has subsided. Conclusion: The findings of this study show that strict attention must be paid to SLE patients on immunosuppressive therapy due to the possible association of CMV retinitis. (C) 2016 The Author(s) Published by S. Karger AG, Basel