细胞巨化病毒慢性视网膜亡与甘西克洛维尔耐药性:一个病例报告
Julia Xia1, Sanjana Kantipudi1, Christopher C Striebich2
1Department of Ophthalmology, University of Colorado School of Medicine, 1675 Aurora Court, F731, Aurora, CO, 80045, USA.
Journal of ophthalmic inflammation and infection
|October 8, 2024
概括
细胞巨化病毒 (CMV) 慢性视网膜亡 (CRN) 可能会对甘西克洛维尔治疗产生耐药性. 与莱特莫维尔和莱夫卢诺米德的联合治疗为治疗抗性CMVCRN提供了有效的替代方案,特别是在类风湿性关节炎患者中.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 细胞巨乳病毒 (CMV) 慢性视网膜亡 (CRN) 是一种罕见的病毒感染,在轻度免疫功能低下的个体.
- 它具有急性视网膜亡和CMV视网膜炎的重叠特征.
- 标准治疗包括联合的静脉注射和全身甘西克洛维尔.
研究的目的:
- 讨论CMV CRN. 具有挑战性的病例的管理.
- 为了突出CMVCRN中的甘西克洛维尔耐药性.
- 探索对抗性病例的替代治疗策略.
主要方法:
- 一个80岁的女性患有类风湿性关节炎并服用免疫抑制剂的案例介绍.
- 通过PCR证实了CMV CRN的诊断.
- 最初使用甘西克洛维尔 (口服和静脉内) 治疗,然后因耐药性而转换为福斯卡内特,莱特莫维尔和莱夫卢诺米德.
主要成果:
- 最初的甘西克洛维尔治疗失败,视网膜炎复发和进展.
- 将其切换为静脉内,口服莱特莫维尔和莱夫卢诺米德导致视网膜炎的解决.
- 用莱特莫维尔和莱夫卢诺米德长期治疗超过2.5年阻止了活性化.
结论:
- 随着非细胞毒性免疫抑制剂的使用增加,CMV CRN的发病率可能会增加.
- 甘西克洛维尔耐药性是一个重大的临床挑战.
- 与莱特莫维尔和莱夫卢诺米德的联合治疗对于抗甘西克洛维尔的CMVCRN是一种可行的选择,莱夫卢诺米德在类风湿性关节炎患者中提供额外的抗炎作用.
相关概念视频
01:27Open Angle Glaucoma: Treatment
1.1K
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
1.1K
01:28Angle Closure Glaucoma: Treatment
1.7K
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
1.7K
01:27Cytomegalovirus Disease
108
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
108
01:27Diabetic Retinopathy
65
DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
65