Tocilizumab for Cystoid Macular Edema Secondary to Immune Recovery Uveitis in a Patient with Contraindications to Long-Term Systemic Corticosteroid.

Autor:	Nguyen BT; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.; Department of Ophthalmology, Viet Nam National Children's Hospital, Ha Noi, Viet Nam., Hung JH; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Thng ZX; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.; National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore., El Feky D; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.; Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt., Mobasserian A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Saengsirinavin AO; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Zhang X; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Anover FA; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Mohammadi SS; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Than NTT; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Khatri A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Yavari N; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Ganbold B; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.; Bolor Melmii Eye Hospital, Ulaanbaatar, Mongolia., Yasar C; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Elaraby O; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Akhavanrezayat A; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Yoo WS; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Gupta AS; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA., Nguyen QD; Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
Jazyk:	angličtina
Zdroj:	The Yale journal of biology and medicine [Yale J Biol Med] 2024 Dec 19; Vol. 97 (4), pp. 423-430. Date of Electronic Publication: 2024 Dec 19 (Print Publication: 2024).
DOI:	10.59249/NQRT7239
Abstrakt:	Purpose : To report a case of cystoid macular edema (CME) secondary to immune recovery uveitis (IRU) in a patient with previous history of cytomegalovirus (CMV) retinitis and leukemia, which was successfully treated with tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist. Method : The clinical records of the case were reviewed, focusing on demographics, image findings, and clinical course. Results : A 17-year-old female with a past medical history of T-cell acute lymphoblastic leukemia (T-ALL) undergoing chemotherapy for two years presented with active CMV retinitis. She was successfully treated with intravitreal foscarnet injections and systemic ganciclovir. After 5 months of systemic valganciclovir maintenance and following cessation of chemotherapy, the patient developed bilateral CME and vasculitis, and was diagnosed with IRU. CME management was challenging due to a history of bilateral avascular necrosis of the femoral head resulting from prolonged systemic corticosteroid use. Two cycles of monthly TCZ infusions were administered at the dosage of 8mg/kg. Subsequently, the CME and retinal vasculitis resolved significantly without any evidence of inflammation in the anterior chamber and vitreous. Conclusion : The index case report demonstrated the safety and efficacy of the IL-6 receptor antagonist TCZ in treating CME associated with IRU in a non-HIV CMV retinitis patient. (Copyright ©2024, Yale Journal of Biology and Medicine.)
Databáze:	MEDLINE
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