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在对类风湿性关节炎的阿帕达西丁单疗期间的细胞巨乳病毒视网膜炎:一个病例报告

Sang Jun Park¹, Yun Jong Lee^2,3,4

¹Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Journal of rheumatic diseases

|December 18, 2025

概括

细胞巨乳病毒视网膜炎 (CMVR) 是一种罕见但严重的并发症,在风湿性关节炎患者使用雅努斯酶抑制剂 (JAKis). 这一案例凸显了JAKis治疗中出现眼部症状的老年患者对CMVR的警的重要性.

科学领域:

眼科医生眼科眼科
类风湿病学类风湿病学
传染性疾病传染性疾病

背景情况:

简氏激酶抑制剂 (JAKis) 与增加病毒再激活的风险有关,包括疹病毒.
在接受JAKis治疗的类风湿性关节炎 (RA) 患者中,细胞巨乳病毒 (CMV) 反激活,特别是CMV视网膜炎 (CMVR) 异常罕见.
CMVR是一种视力威胁的疾病,通常在免疫受损的个体中见到.

研究的目的:

报告韩国首例CMV视网膜炎病例,该病例发生在一名风湿性关节炎患者身上,该患者接受了Janus激酶抑制剂upadacitinib的治疗.
审查现有的关于RA患者生物药物或JAKis治疗的CMVR的文献.
强调早期诊断和管理CMVR在老年RA患者在JAKis的重要性.

主要方法:

一个75岁的韩国男性的病例报告,他接受了阿帕达西尼布治疗,患上了亚急性视力模糊.
眼科检查,包括对急性视网膜亡和CMVR的评估.
用于证实CMV的水性幽默的聚合酶连锁反应测试.
在RA患者中报告的CMVR病例的文献综述.

主要成果:

该患者通过水性的PCR诊断出CMVR.
用内甘西克洛维尔治疗导致症状无重大并发症消失.
文献审查发现了RA患者中以前的七例CMVR病例,主要与生物药物或JAKis有关.
晚年被确定为一个重要的风险因素.

结论:

在接受JAKis (如upadacitinib) 治疗的老年RA患者中,CMVR是一种罕见但潜在的并发症.
临床医生应在接受JAKis治疗的老年RA患者中保持对CMVR的高度怀疑指数,这些患者呈现眼部症状.
及时诊断和治疗对于预防视力丧失至关重要.

关键词:

抗风湿剂是一种抗风湿剂.细胞巨乳病毒视网膜炎类风湿性关节炎类风湿性关节炎类风湿性关节炎在Upadacitinib上使用.

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