Zahra Mahdizad, Mohammad Zarei, Hanieh Fakhredin, Reza Samiee, Hora Heidari, Nazanin Ebrahimiadib
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引用次数: 0
摘要
背景:报告一例使用局部和全身药物治疗的小儿多发性硬化症相关葡萄膜炎病例:一名11岁的男孩在另一家医院被诊断为小儿多发性硬化症(POMS),首次表现为左侧视神经炎,后转诊至我院,主诉为左眼视力无改善,尽管已静脉滴注5gr甲基强的松龙。眼科检查后,患者被诊断为双侧 POMS 相关性中葡萄膜炎,双眼均接受了皮质类固醇局部治疗。他继续接受利妥昔单抗等全身治疗,并进行了五次浆细胞分离术。四个月后,患者左眼的视力从 50 厘米处的 FC 提高到 9/10。双眼的眼内炎症强度均有所下降。荧光素血管造影结果显示,双侧视盘和血管渗漏均已消退:尽管POMS相关葡萄膜炎非常罕见,但它仍是一个巨大的挑战,需要神经科医生和眼科医生通力合作,才能取得最有效的治疗效果。
A case report of pediatric-onset MS associated uveitis.
Background: To report a case of Pediatric-onset MS associated uveitis managed with local and systemic medications.
Case presentation: An 11-year-old boy who was diagnosed with Pediatric-onset MS (POMS) with the first presentation of left optic neuritis in another center, was referred to our clinic with the complaint of non-improved vision in the left eye despite receiving IV 5gr methylprednisolone. After the ophthalmologic examinations, the patient was diagnosed as bilateral POMS-associated intermediate uveitis, and local treatment with corticosteroid was administered to both eyes. He was continued on systemic therapy such as Rituximab and five sessions of plasmapheresis. After four months, the patient's vision improved from FC at 50cm to 9/10 in the left eye. The intensity of intraocular inflammation decreased in both eyes. In fluorescein angiography findings, the optic disc, as well as vascular leakage, subsided bilaterally.
Conclusion: Despite its rarity, POMS-associated uveitis presents a considerable challenge that necessitates the collaborative efforts of neurologists and ophthalmologists to achieve the most effective treatment outcomes.