PDF(Pubmed)
Abstract：
Acute retinal necrosis (ARN) is an inflammatory disease that is primarily caused by herpesvirus infection, most commonly varicella-zoster virus (VZV), followed by herpes simplex virus (HSV) and occasionally cytomegalovirus (CMV). Sintilimab is an immune checkpoint inhibitor (ICI) that can enhance the body\'s anti-tumor immune response. However, treatment with ICIs may lead to reactivation of the VZV. Here, we present a case of ARN caused by VZV infection in a patient receiving sintilimab for cervical cancer. A 64-year-old female patient developed vision loss and floaters with left eye redness for one week after 22 cycles of sintilimab for cervical cancer. Based on clinical manifestations, ophthalmological examination, and vitreous humor biopsy, the patient was diagnosed with acute retinal necrosis syndrome secondary to VZV. After receiving systemic antiviral and anti-inflammatory therapy, retinal necrosis lesions and visual function improved. In conclusion, clinicians should be aware of the risk of ARN when using sintilimab and should actively monitor patients for prompt diagnosis and optimal management of this rare adverse drug reaction.
摘要：
急性视网膜坏死（ARN）是一种主要由疱疹病毒感染引起的炎症性疾病，最常见的水痘-带状疱疹病毒（VZV），其次是单纯疱疹病毒（HSV）和偶尔巨细胞病毒（CMV）。Sintilimab是一种免疫检查点抑制剂（ICI），可以增强人体的抗肿瘤免疫反应。然而,用ICIs治疗可能导致VZV的再激活。这里,我们介绍了1例接受sintilimab治疗宫颈癌的患者中由VZV感染引起的ARN病例。一名64岁的女性患者在接受22个周期的sintilimab治疗宫颈癌后一周出现视力丧失和左眼发红的漂浮物。根据临床表现，眼科检查,和玻璃体活检，患者被诊断为继发于VZV的急性视网膜坏死综合征。在接受全身抗病毒和抗炎治疗后，视网膜坏死病变和视功能改善。总之,临床医生在使用sintilmab时应意识到ARN的风险,并应积极监测患者,以便及时诊断和优化治疗这种罕见的药物不良反应.
