角膜移植术后眼部淋巴细胞增生性疾病

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-07-23 DOI:10.1016/j.ajoc.2025.102397

Linna Liu, Xiangxi Chen, Jianhua Wu, Guohua Wang, Jing Yan, Rui Zhang

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引用次数: 0

摘要

目的eb病毒相关的移植后淋巴细胞增生性疾病（PTLD）是实体器官或同种异体造血干细胞移植后的常见疾病。但是角膜移植术后的眼部受累仍然是一种罕见的发现，并且很容易被误诊。我们报告一例59岁男性患者在穿透性角膜移植术后4个月出现右眼假面性葡萄膜炎，最终被诊断为眼部PTLD。诊断依据是水样中存在eb病毒DNA，虹膜标本显示存在B细胞克隆。经玻璃体内注射甲氨蝶呤15次后，眼部状况完全缓解。结论及重要性角膜移植术后局部免疫抑制可导致眼部PTLD。眼内液和组织或细胞学活检中检测eb病毒DNA有助于确诊。

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Ocular post-transplant lymphoproliferative disorder after keratoplasty

Purpose

Epstein-Barr virus associated post-transplantation lymphoproliferative disorders (PTLD) is a common condition after solid-organ or allogeneic hematopoietic stem-cell transplants. But ocular involvement after keratoplasty remains a rare finding, and can be easily misdiagnosed.

Observations

We report a case of a 59-year-old man who presented with masquerade uveitis of right eye 4 months post penetrating keratoplasty and was ultimately diagnosed with ocular PTLD. The diagnosis relied on the presence of Epstein-Barr virus DNA in aqueous sample and iris specimens showed the presence of a B cell clone. The ocular condition was in complete remission after 15 intravitreal injections of methotrexate.

Conclusions and Importance

Local immunosuppression after keratoplasty can lead to ocular PTLD. Detection of Epstein-Barr virus DNA in intraocular fluid and tissue or cytological biopsy could help confirm the diagnosis.

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.