肺结核免疫反应性试验阴性患者的结核Serpignous样脊椎炎。

IF 2.6 4区医学 Q2 OPHTHALMOLOGY Ocular Immunology and Inflammation Pub Date : 2024-10-01 Epub Date: 2023-09-28 DOI:10.1080/09273948.2023.2258399

Sucheta Ireni, Vidya S Mooss, Anup Kelgaonkar, Kalpana Babu, Soumyava Basu

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引用次数: 0

摘要

背景：在结核菌素皮肤试验（TST）或干扰素γ释放试验（IGRA）呈阳性的情况下，脉络膜样脉络膜炎（SLC）表示眼结核病（TB）。方法：回顾性审查来自结核病流行国家的SLC患者，TST和IGRA试验呈阴性，但对抗TB治疗有反应。结果：15例（13例双侧）活动性SLC患者包括在内。 11名（73.3%）患者接受了皮质类固醇治疗 ± 在出现之前进行免疫抑制治疗。在4名（26.7%）患者中发现胸部放射学异常。我们对所有患者进行了抗结核治疗（ATT）和皮质类固醇的联合治疗。9名（60%）患者出现矛盾性恶化，12名（80%）患者病变完全消退，1名患者持续炎症（ATT后），2名患者尚未完全ATT。没有一名患者在病变完全消退后复发（中位随访71 周[范围15-676 结论：TB-SLC可能表现为TST和IGRA测试阴性，但可能仍有临床表现和治疗反应，如测试阳性疾病。

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Tubercular Serpiginous-Like Choroiditis in Patients with Negative TB-Immunoreactivity Tests.

Background: Serpiginous-like choroiditis (SLC) denotes ocular tuberculosis (TB), in the presence of positive tuberculin skin test (TST) or interferon gamma release assay (IGRA).

Methods: Retrospective review of SLC patients from a TB-endemic country, with negative TST and IGRA tests, but responsive to anti-TB therapy.

Results: Fifteen patients (13 bilateral) with active SLC were included. Eleven (73.3%) patients had received corticosteroids ± immunosuppressive therapy prior to presentation. Chest radiographic abnormalities were found in four (26.7%) patients. We treated all patients with a combination of anti-TB therapy (ATT) and corticosteroids. Paradoxical worsening was noted in nine (60%) patients, complete resolution of lesions in 12 (80%), persistent inflammation (post-ATT) in one, while two were yet to complete ATT. None had recurrence after complete resolution of lesions (median follow-up of 71 weeks [range 15-676 weeks]).

Conclusions: TB-SLC may present with negative TST and IGRA tests but may still have clinical appearance, and treatment response, like test-positive disease.

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.

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