RESUMO
PURPOSE: To evaluate the clinical outcome and safety of adalimumab in patients with Vogt-Koyanagi-Harada (VKH) disease. METHODS: VKH patients treated with adalimumab seen at the University of Buenos Aires were reviewed. Main outcome measures were visual acuity, anterior segment inflammation, optic nerve inflammation (ONI), steroid sparing effect, number of immunosuppressives, and relapses. RESULTS: In total, 14 VKH patients, mean age 23.07 ± 8 years; median of adalimumab treatment 10 months, were analyzed. At start of adalimumab treatment (baseline), median of corticosteroid dose was 20 mg and at 6 months, 4 mg. At baseline, 11 patients were on immunosuppressive treatment and at 6 months only four continued with immunosuppressive therapy. In the 28 eyes, the median of active inflammation was 2 at baseline and 0 after 6 months on adalimumab. CONCLUSIONS: Treatment with adalimumab is an effective and safe option, reducing the need for oral corticosteroid and conventional immunosuppressive therapy.
Assuntos
Anti-Inflamatórios/uso terapêutico , Síndrome Uveomeningoencefálica/tratamento farmacológico , Adalimumab/efeitos adversos , Adalimumab/uso terapêutico , Adolescente , Adulto , Anti-Inflamatórios/efeitos adversos , Criança , Feminino , Glucocorticoides/uso terapêutico , Humanos , Terapia de Imunossupressão , Masculino , Prednisolona/uso terapêutico , Recidiva , Síndrome Uveomeningoencefálica/fisiopatologia , Acuidade Visual/fisiologia , Adulto JovemAssuntos
Microcefalia , Zika virus , Brasil , Humanos , Complicações Infecciosas na Gravidez , Infecção por Zika virusRESUMO
METHODS: Case description of a 34 year old woman with chronic granulomatous anterior uveitis following implantation of a phakic anterior chamber intraocular lens (IOL). Aqueous humor was processed for bacterial, fungal culture, and PCR analysis. RESULTS: PCR for 16S ribosomal RNA universal primers was positive and Southern-blot for Propionibacterium spp was negative. Panfungal PCR was negative. Growth of a pigmented yellow colony was detected on Lowenstein-Jensen medium. The isolate was subsequently identified as Mycobacterium gordonae. The patient was treated for atypical mycobacteria as well as an intracameral injection of moxifloxacin, with resolution of inflammation and improvement in visual acuity. CONCLUSIONS: This is the first reported case of Mycobacterium gordonae chronic postoperative endophthalmitis, and of chronic endophthalmitis following phakic IOL surgery. PCR and cultures were invaluable in making the diagnosis.