在复发性复发性多发性硬化症的病例中,与芬戈利莫德相关的加密球菌冠状炎和骨性加密球菌病
Ishta Sharma1, Dalia Abdulhussein2, Neda Minakaran2
1Medicine, King's College London, London, UK k2258901@kcl.ac.uk.
BMJ case reports
|February 7, 2025
概括
多发性硬化症的芬戈利莫德治疗可以导致严重的真菌感染,如脊髓和眼球密码菌. 这一案例凸显了对免疫抑制患者感染的警的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 神经学 神经学
- 眼科医生 眼科 眼科
背景情况:
- 多发性硬化症 (MS) 是一种慢性自身免疫性疾病,影响中枢神经系统.
- 芬戈利莫德是一种口服免疫调节剂,用于通过在淋巴结中捕获淋巴细胞来治疗复发性复发性多发性硬化症.
- 慢性免疫抑制会增加机会性感染的风险.
研究的目的:
- 在长期接受fingolimod治疗的MS患者中报告一种罕见的脊柱和眼球密码球菌病例.
- 强调在接受免疫抑制治疗多发性硬化症的患者中识别机会性感染的重要性.
主要方法:
- 一个年轻的成年男性患有复发性复发性MS的病例报告.
- 在偶然的放射学发现后,通过脊椎活检诊断骨质密码菌病.
- 对眼部症状进行临床评估,从而诊断出加密球菌胆管炎.
主要成果:
- 患者患有脊柱密码球菌病和双边胆道病变,与密码球菌胆道炎一致.
- 感染发生在fingolimod治疗8年后.
- 观察到眼部症状 (浮动物),但视力仍然正常,尽管胸腔病变.
结论:
- 这是第一个报告的Cryptococcal Choroiditis病例,该病例是因fingolimod治疗而引起的.
- 强调长期使用fingolimod可能导致严重的机会性感染,包括眼部表现.
- 强调需要在免疫抑制多发性硬化症患者中对感染的高度临床怀疑.
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