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Sepsis During Immunosuppression for Sight-threatening Uveitis: The Flip side
1a Manchester Royal Eye Hospital , Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK; Medical Academic Health Science Centre, University of Manchester , Manchester , UK.
Ocular Immunology and Inflammation
|August 20, 2016
Summary
Immunosuppression for sight-threatening uveitis can lead to rare but severe infections. Patients must understand these risks, as prophylaxis efficacy is unproven.
Area of Science:
- Ophthalmology
- Immunology
- Infectious Diseases
Background:
- Uveitis, a sight-threatening inflammatory eye condition, often requires immunosuppressive therapy.
- Immunosuppression and biologic treatments carry a risk of serious infections.
Observation:
- A retrospective case series identified four immunosuppressed patients with uveitis who developed sepsis.
- These patients were on high-dose prednisolone and various oral immunosuppressants, with one receiving infliximab.
Findings:
- All four patients survived after intensive medical treatment for sepsis.
- The study highlights the potential for life-threatening infections in this patient population.
Implications:
- Physicians should counsel patients on the rare but significant risk of severe infection before initiating immunosuppressive therapy for uveitis.
- Current prophylaxis strategies for infection in these patients have unproven efficacy.
- Informed consent is crucial, emphasizing the balance between managing uveitis and mitigating infection risks.
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