NEJM:坏死性巩膜炎-病例报道

2020-11-05 MedSci原创 MedSci原创

患者开始使用静脉糖皮质激素和环磷酰胺治疗,该患者接受巩膜移植和羊膜移植手术修复。该患者还从同一只眼接受了结膜自体移植。她完成了逐渐减量口服糖皮质激素疗程,并将免疫抑制疗法改为口服甲氨蝶呤。

患者为一名73岁的女性,伴有血清反应性糜烂类风湿关节炎病史,因其右眼疼痛1个月而到急诊就诊。就诊前四年,她已停止免疫抑制治疗,改用替代疗法。

患眼的视力为20/25。裂隙灯检查显示充血,炎症和明显的巩膜变薄以及潜在脉络膜暴露。实验室检查发现类风湿因子水平升高,红细胞沉降速率增加,抗中性粒细胞胞浆抗体测试结果阴性,诊断为坏死性前巩膜炎伴炎症。

患者开始使用静脉糖皮质激素和环磷酰胺治疗,该患者接受巩膜移植和羊膜移植手术修复。该患者还从同一只眼接受了结膜自体移植。她完成了逐渐减量口服糖皮质激素疗程,并将免疫抑制疗法改为口服甲氨蝶呤。

术后三个月的随访中,患者眼部炎症和疼痛已缓解,患者的视力得以保留。

原始出处:

Natalia Lorenzana Blanco,et al.Necrotizing Scleritis.N Engl J Med.2020;https://www.nejm.org/doi/full/10.1056/NEJMicm2004836

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1944307, encodeId=21ea194430e8c, content=<a href='/topic/show?id=587a4825067' target=_blank style='color:#2F92EE;'>#巩膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48250, encryptionId=587a4825067, topicName=巩膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Sun Feb 21 01:11:53 CST 2021, time=2021-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362994, encodeId=31431362994f2, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Fri Nov 06 23:11:53 CST 2020, time=2020-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035480, encodeId=bbf710354801a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 05 11:11:53 CST 2020, time=2020-11-05, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1944307, encodeId=21ea194430e8c, content=<a href='/topic/show?id=587a4825067' target=_blank style='color:#2F92EE;'>#巩膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48250, encryptionId=587a4825067, topicName=巩膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Sun Feb 21 01:11:53 CST 2021, time=2021-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362994, encodeId=31431362994f2, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Fri Nov 06 23:11:53 CST 2020, time=2020-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035480, encodeId=bbf710354801a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 05 11:11:53 CST 2020, time=2020-11-05, status=1, ipAttribution=)]
    2020-11-06 millore
  3. [GetPortalCommentsPageByObjectIdResponse(id=1944307, encodeId=21ea194430e8c, content=<a href='/topic/show?id=587a4825067' target=_blank style='color:#2F92EE;'>#巩膜炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48250, encryptionId=587a4825067, topicName=巩膜炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8143398, createdName=lily1616, createdTime=Sun Feb 21 01:11:53 CST 2021, time=2021-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362994, encodeId=31431362994f2, content=<a href='/topic/show?id=b723414321c' target=_blank style='color:#2F92EE;'>#坏死#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41432, encryptionId=b723414321c, topicName=坏死)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Fri Nov 06 23:11:53 CST 2020, time=2020-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035480, encodeId=bbf710354801a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 05 11:11:53 CST 2020, time=2020-11-05, status=1, ipAttribution=)]
    2020-11-05 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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