Identification ofcytomegalovirus and human herpesvirus-6 DNA in a patient with corneal endotheliitis
Identification ofcytomegalovirus and human herpesvirus-6 DNA in a patient with corneal endotheliitis
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角膜内皮炎患者巨细胞病毒和人疱疹病毒6型DNA的鉴定
DOI：
10.1007/s10384-012-0223-7
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发表时间：
2013
期刊：
影响因子：
2.4
通讯作者：
Sugiyama K
中科院分区：
文献类型：
--
作者：
Yokogawa H;Kobayashi A;Yamazaki N;Sugiyama K
目的报告一例单侧角膜内皮炎患者房水中同时检测到巨细胞病毒（CMV）和人疱疹病毒-6 (HHV6) DNA。一例67岁男性角膜内皮炎患者因视力下降而就诊。在裂隙灯生物显微镜下观察到局部角膜间质水肿、色素沉淀、硬币状病变及轻微前房反应。在体激光共聚焦显微镜下观察内皮细胞层猫头鹰眼样细胞。患者患有类风湿关节炎，经口服强的松龙和静脉注射阿巴接受治疗。聚合酶链反应分析的房水样品检测到CMV和HHV6的DNA，但没有其他hhv。局部使用更昔洛韦和全身使用缬更昔洛韦治疗可获得透明的角膜。结论1例角膜内皮炎患者房水中同时检测到CMV和HHV6 DNA。虽然在本病例中发现了两种病毒，但临床表现与CMV角膜内皮炎相似，HHV6是否会影响临床病程尚不清楚。在CMV和HHV6 DNA同时存在的角膜内皮炎病例中，全身阿巴接受和皮质类固醇治疗可能发挥积极作用。
PurposeTo report the case of a patient with unilateral corneal endotheliitis in which both cytomegalovirus (CMV) and human herpesvirus-6 (HHV6) DNA was identified in the aqueous humor.CaseA 67-year-old man with corneal endotheliitis OD was referred to us for decreased visual acuity. Local corneal stromal edema, pigmented keratic precipitates, a coin-shaped lesion and minimal anterior chamber reaction were observed by slit-lamp biomicroscopy. Cells with owl’s eye appearance in the endothelial cell layer were observed by in vivo laser confocal microscopy. The patient had rheumatoid arthritis, which was treated by oral prednisolone and intravenous abatacept. Polymerase chain reaction analysis of aqueous humor samples detected both CMV and HHV6 DNA, but not other HHVs. Treatment with topical ganciclovir and systemic valganciclovir resulted in a clear cornea.ConclusionsA patient with corneal endotheliitis had both CMV and HHV6 DNA identified in the aqueous humor. Although both viruses were identified in this case, clinical manifestations resembled CMV corneal endotheliitis, and it was unclear whether HHV6 could affect the clinical course. Systemic abatacept and corticosteroid therapy might play a positive role in cases with both CMV and HHV6 DNA in this corneal endotheliitis.