在移植后患者的CMV神经网膜炎
Louis Antoine Bonnet1,2, Kay Frances Evans3
1Department of Ophthalmology, University of Otago - Dunedin Campus, Dunedin, New Zealand labonnet101@gmail.com.
BMJ case reports
|December 7, 2023
概括
本案例报告详细介绍了一例罕见的神经网膜炎病例,该病例发生在免疫抑制性肝移植接受者身上. 及时的抗病毒和类固醇治疗导致显著的视觉恢复,突出了细胞巨乳病毒 (CMV) 作为潜在的原因.
科学领域:
- 眼科医生 眼科 眼科
- 移植免疫学 移植免疫学
- 传染性疾病 传染性疾病
背景情况:
- 神经网膜炎是一种炎症状况,影响视神经和视网膜.
- 器官移植后的免疫抑制增加了对机会性感染的易感性.
- 细胞巨乳病毒 (CMV) 是移植受体中常见的机会性病原体.
研究的目的:
- 报告一个非典型的表现神经网膜炎在一个后 ортотоп性肝移植患者.
- 为了研究细胞巨乳病毒 (CMV) 在免疫功能低下个体中神经网膜炎的发展中的潜在作用.
- 描述这种罕见疾病的临床过程和治疗结果.
主要方法:
- 一个40多岁的男性患者的病例报告,呈现出单方面视力损失.
- 眼科检查,包括视力敏度和眼底镜检查.
- 对包括CMV在内的传染病原体进行血清检测.
- 用抗病毒疗法和全身皮质类固醇治疗.
主要成果:
- 该患者出现了严重的单侧视力损失 (6/36) 和神经网膜炎的特征性症状,包括视觉盘胀和黄斑胀.
- 调查显示了细胞巨乳病毒 (CMV) IgG和IgM的阳性血清学.
- 在治疗后,视力敏度显著改善至6/4.5.5.
结论:
- 神经网膜炎可以在免疫功能低下的患者中呈现异常,即使没有艾滋病.
- 在移植后患者的神经网膜炎的差分诊断中应考虑细胞巨乳病毒 (CMV).
- 早期诊断和适当的抗病毒和抗炎治疗对于视力恢复至关重要.
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