Systemic adalimumab induces peripheral corneal infiltrates: a case report

BMC Ophthalmology

Case Report

Jacques Cosnes¹  Talal Beydoun²  Jean-Louis Bourges²  Alexandre Matet³  Alejandra Daruich³ 

[1] Department of Gastroenterology, Saint-Antoine Hospital, AP-HP, and Pierre et Marie Curie University, 184 rue du Faubourg Saint-Antoine 75012, Paris, France;Department of Ophthalmology, Hotel-Dieu Hospital, AP-HP, and Sorbonne Paris Cité University, Paris Descartes faculty of medicine, 1 place du parvis Notre-Dame 75004, Paris, France;Department of Ophthalmology, Hotel-Dieu Hospital, AP-HP, and Sorbonne Paris Cité University, Paris Descartes faculty of medicine, 1 place du parvis Notre-Dame 75004, Paris, France;Department of ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des aveugles, Avenue de France 15, 1004, Lausanne, Switzerland;

关键词: Cornea;    Adalimumab;    Tumor necrosis factor-alpha inhibitor;    Adverse effects;    Peripheral infiltrate;    Crohn's disease;   

DOI  :  10.1186/s12886-015-0047-6

 received in 2014-01-27, accepted in 2015-05-29,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundTumor necrosis factor-alpha inhibitors are widely used agents in the treatment of immune disorders such as rheumatoid arthritis and inflammatory bowel disease. Despite their anti-inflammatory action, paradoxical drug-induced inflammatory events have been occasionally associated with the use of infliximab, etanercept, and in a lesser extent adalimumab. However, eye involvement is uncommon and anterior uveitis is the only reported ocular adverse manifestation. It can be induced by etanercept, but has also been described during adalimumab therapy. We present here the first report of recurrent peripheral corneal infiltrates following subcutaneous injections of adalimumab.Case presentationA 34 year-old Caucasian woman with Crohn’s disease presented to the emergency department with bilateral red eyes and discomfort 36 hours after she received her bimonthly dose of subcutaneous adalimumab. Examination revealed bilateral peripheral corneal infiltrates with characteristic features of immune infiltrates. Symptoms and infiltrates regressed after topical corticosteroid therapy, but recurred after each adalimumab injection over the following weeks.ConclusionParadoxical immune reactions associated with tumor necrosis factor-alpha inhibitors may result either from hypersensitivity mechanisms, or from immune-complex deposition via anti-adalimumab antibodies. Both mechanisms could explain this newly described manifestation. Care should be taken to search for corneal infiltrates in the event of red eye symptoms during adalimumab therapy since they respond to topical corticosteroids and do not necessarily prompt the discontinuation of the immunosuppressive therapy.

【 授权许可】

Unknown   
© Matet et al. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.