春季角膜结膜炎是一种持续的过敏性眼病,主要由T辅助细胞2淋巴细胞相关的免疫反应介导。春季角膜结膜炎的标准治疗方法包括局部皮质类固醇和免疫抑制眼药水。然而,在季节性加重的时期,仅通过局部治疗来管理春季角膜结膜炎变得具有挑战性。全身治疗如口服皮质类固醇或环孢素可能是替代选择。最近,dupilumab在难治性春季角膜结膜炎治疗中的疗效已有文献报道。这里,我们报道了一例难治性春季角膜结膜炎合并特应性皮炎的病例,在upadacitinib给药后病情迅速好转.一名18岁的日本女性出现特应性皮炎,春季角膜结膜炎,和花粉热。在冬天,患者出现广泛的红斑和瘙痒加剧,导致严重的不适和失眠。由于难以维持她目前的治疗方案,upadacitinib(15毫克),启动了Janus激酶抑制剂.upadacitinib给药后,治疗耐药的春季角膜结膜炎和红斑得到改善。Upadacitinib在特应性皮炎的严重病例中是有益的。因此,在我们的案例中,upadacitinib可能通过改善T-helper1/2型免疫反应为难治性春季结膜炎提供治疗益处,自身免疫,和氧化应激。据我们所知,这是首次报告显示upadacitinib在治疗重度春季结膜炎方面的潜在效用.
Vernal keratoconjunctivitis is a persistent allergic ocular disease predominantly mediated by the T-helper 2 lymphocyte-associated immune response. The standard therapeutic approaches for vernal keratoconjunctivitis include topical corticosteroids and immunosuppressive eye drops. However, managing vernal keratoconjunctivitis with only topical treatments becomes challenging during seasonally exacerbated periods. Systemic treatments such as oral corticosteroids or cyclosporine may be alternative options. Recently, dupilumab\'s efficacy in refractory vernal keratoconjunctivitis treatment has been documented. Here, we report a
case of refractory vernal keratoconjunctivitis coexisting with atopic dermatitis that rapidly improved after
upadacitinib administration. An 18-year-old Japanese woman presented with atopic dermatitis, vernal keratoconjunctivitis, and hay fever. In winter, the patient experienced widespread erythema and escalated itching, leading to significant discomfort and insomnia. Owing to the difficulty in maintaining her current regimen, upadacitinib (15 mg), a Janus kinase inhibitor was initiated. After upadacitinib administration, the treatment-resistant vernal keratoconjunctivitis and erythema improved.
Upadacitinib is beneficial in severe cases of atopic dermatitis. Consequently, in our
case,
upadacitinib may offer therapeutic benefits for refractory vernal conjunctivitis by improving the T-helper 1/2 type immune response, autoimmunity, and oxidative stress. To our knowledge, this is the first report suggesting the potential utility of
upadacitinib in managing severe vernal conjunctivitis.