在克罗恩病中双边角膜,以及假定与阿达利穆马布相关的眼睛表面疾病
Nefeli Eleni Kounatidou1, Johannes Birtel1, Nicole Stuebiger1
1Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
American journal of ophthalmology case reports
|December 31, 2025
概括
长期服用瘤缩因子 (TNF) - - α抑制剂阿达利穆马布的过量服用导致一名年轻克罗恩病患者的双侧角膜失效. 停止服用药物并转换为维多利祖马布可以解决危及视力的眼部并发症.
科学领域:
- 眼科医生 眼科 眼科
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 抗瘤坏死因子 (TNF) -α抑制剂对于炎症性肠病 (IBD) 管理至关重要.
- 虽然通常是安全的,但高剂量或长时间使用可能会导致皮肤和眼部的副作用.
- Corneal pannus 是一种罕见但严重的并发症,与 TNF-α 抑制剂治疗有关.
研究的目的:
- 报告一个患有克罗恩氏病的患者因阿达利穆马布过量服用而出现双边角膜的病例.
- 为了突出TNF-α抑制剂管理不善可能导致严重的眼部并发症.
- 强调警监测IBD患者不良影响的重要性.
主要方法:
- 一名患有克罗恩病的19岁男性出现了视力模糊和光恐惧症.
- 临床检查显示,严重的双边角膜与新血管化.
- 该患者报告了两年来每周服用阿达利穆姆巴的病史,而不是处方的每两周一次剂量.
- 治疗包括停用阿达利穆马布,启动维多利祖马布和支持性局部/全身疗法.
主要成果:
- 在停用阿达利穆马布和开始服用维多利祖马布后,该患者经历了角膜瘤的显著回归.
- 最好的校正视觉敏度有所改善,眼部症状如结膜注射和光敏度明显下降.
- 在四个月内观察到视觉功能的完全恢复和眼睛表面疾病的消失.
结论:
- 双边角膜瘤是长期抗TNF-α治疗的罕见但显著的眼部并发症,特别是在过量服用时.
- 接受免疫抑制剂的年轻IBD患者需要仔细监测皮肤和眼部不良事件.
- 迅速修改免疫抑制剂和向治疗对于预防严重病例不可逆转的视力丧失至关重要.
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