Cargando…
Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery
PURPOSE: Immune reconstitution uveitis (IRU) is a well-described phenomenon that by definition occurs in patients with AIDS who undergo highly active antiretroviral therapy resulting in a rebound inflammatory response to the presence of clinically latent cytomegalovirus (CMV). We hypothesize that si...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757366/ https://www.ncbi.nlm.nih.gov/pubmed/29503889 http://dx.doi.org/10.1016/j.ajoc.2016.04.005 |
_version_ | 1783290846554095616 |
---|---|
author | Kavoussi, Shaheen C. Kovacs, Kyle D. Alasil, Tarek Coady, Patrick Kombo, Ninani |
author_facet | Kavoussi, Shaheen C. Kovacs, Kyle D. Alasil, Tarek Coady, Patrick Kombo, Ninani |
author_sort | Kavoussi, Shaheen C. |
collection | PubMed |
description | PURPOSE: Immune reconstitution uveitis (IRU) is a well-described phenomenon that by definition occurs in patients with AIDS who undergo highly active antiretroviral therapy resulting in a rebound inflammatory response to the presence of clinically latent cytomegalovirus (CMV). We hypothesize that similar phenomena may exist in other cohorts who undergo transient immunosuppression with rapid white blood cell count recovery. OBSERVATIONS: A patient developed rebound inflammation a few months after cataract surgery with intraocular lens placement characterized by photophobia, significant anterior chamber cell and fibrinous deposits. She had a history of multiple myeloma treated with chemotherapy and a recovery of white blood cell counts following autologous bone marrow transplant. She underwent a thorough work-up for infectious etiologies, as well as the presence of intraocular CMV, which were negative. Her vision and symptoms improved to baseline with the use of topical steroids and at one year her exam remained stable. CONCLUSIONS AND IMPORTANCE: With a negative work-up for infectious etiologies, and the timing and clinical presentation, the patient's inflammation was likely the result of rapid white blood cell count recovery following iatrogenic immunosuppression similar to the mechanism described for IRU. |
format | Online Article Text |
id | pubmed-5757366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-57573662018-03-02 Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery Kavoussi, Shaheen C. Kovacs, Kyle D. Alasil, Tarek Coady, Patrick Kombo, Ninani Am J Ophthalmol Case Rep Article PURPOSE: Immune reconstitution uveitis (IRU) is a well-described phenomenon that by definition occurs in patients with AIDS who undergo highly active antiretroviral therapy resulting in a rebound inflammatory response to the presence of clinically latent cytomegalovirus (CMV). We hypothesize that similar phenomena may exist in other cohorts who undergo transient immunosuppression with rapid white blood cell count recovery. OBSERVATIONS: A patient developed rebound inflammation a few months after cataract surgery with intraocular lens placement characterized by photophobia, significant anterior chamber cell and fibrinous deposits. She had a history of multiple myeloma treated with chemotherapy and a recovery of white blood cell counts following autologous bone marrow transplant. She underwent a thorough work-up for infectious etiologies, as well as the presence of intraocular CMV, which were negative. Her vision and symptoms improved to baseline with the use of topical steroids and at one year her exam remained stable. CONCLUSIONS AND IMPORTANCE: With a negative work-up for infectious etiologies, and the timing and clinical presentation, the patient's inflammation was likely the result of rapid white blood cell count recovery following iatrogenic immunosuppression similar to the mechanism described for IRU. Elsevier 2016-04-14 /pmc/articles/PMC5757366/ /pubmed/29503889 http://dx.doi.org/10.1016/j.ajoc.2016.04.005 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Kavoussi, Shaheen C. Kovacs, Kyle D. Alasil, Tarek Coady, Patrick Kombo, Ninani Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title | Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title_full | Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title_fullStr | Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title_full_unstemmed | Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title_short | Delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
title_sort | delayed bilateral fibrinous anterior chamber reaction following autologous bone marrow transplant and cataract surgery |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757366/ https://www.ncbi.nlm.nih.gov/pubmed/29503889 http://dx.doi.org/10.1016/j.ajoc.2016.04.005 |
work_keys_str_mv | AT kavoussishaheenc delayedbilateralfibrinousanteriorchamberreactionfollowingautologousbonemarrowtransplantandcataractsurgery AT kovacskyled delayedbilateralfibrinousanteriorchamberreactionfollowingautologousbonemarrowtransplantandcataractsurgery AT alasiltarek delayedbilateralfibrinousanteriorchamberreactionfollowingautologousbonemarrowtransplantandcataractsurgery AT coadypatrick delayedbilateralfibrinousanteriorchamberreactionfollowingautologousbonemarrowtransplantandcataractsurgery AT komboninani delayedbilateralfibrinousanteriorchamberreactionfollowingautologousbonemarrowtransplantandcataractsurgery |