Combination of azathioprine and corticosteroids in the treatment of serpiginous choroiditis.

Can J Ophthalmol 2006 Apr;41(2):183-9

Uveitis and Ocular Immunology Unit, Department of Ophthalmology, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

Background: Although therapy with immunosuppressive agents is currently accepted as the best option for treating active serpiginous choroiditis (SC), there is no consensus on the most effective immunosuppressive drug to use. In this paper, we describe the clinical course of patients with active SC treated with azathioprine (AZA) in combination with corticosteroids.

Methods: This retrospective study included 4 patients (5 eyes) with active, vision-threatening SC who received systemic immunosuppression with AZA at 1.5 to 2.0 mg/kg per day. In combination with oral AZA, patients also received 1 mg/kg oral prednisone per day. Information collected included Snellen visual acuity (VA), clinical disease activity, duration of follow-up, rate of inflammation recurrence, and side effects of AZA.

Results: Within 3 weeks of treatment, all patients experienced decreased ocular inflammation and improved VA. One patient, however, had a recurrence in both eyes while oral prednisone was being tapered. In this case, once the dosage of oral prednisone was increased and methotrexate was added to the therapeutic scheme, inflammation was controlled within 1 month. The other 3 patients presented no further visual loss while on AZA and were able to taper and then discontinue oral prednisone. Nevertheless, SC recurred in 1 of these patients 40 months after the initial treatment. AZA was reintroduced but the patient complained of gastrointestinal problems, and it was then successfully replaced by mycophenolate mofetil. None of the 4 patients presented serious systemic side effects secondary to AZA.

Interpretation: This study suggests that when AZA is used in combination with corticosteroids it is a safe and acceptable option for treating patients with active SC. Side effects and recurrences while on AZA therapy can occur, requiring either replacement of the drug or addition of another immunosuppressive agent.

Download full-text PDF

Source
http://dx.doi.org/10.1139/I06-006DOI Listing
April 2006
Save 15% Survey

Similar Publications

A case of successful pembrolizumab rechallenge in a patient with non-small-cell lung cancer and grade 3 dermatomyositis.

Immunotherapy 2021 Feb 25. Epub 2021 Feb 25.

Department of Medical Oncology, Queen's University, Kingston K7L 2V7, Canada.

We report a case of dermatomyositis in a 59-year old female with advanced non-small-cell lung cancer post one cycle of first-line pembrolizumab monotherapy. Her symptoms resolved with high-dose methyl-prednisolone and subsequent prolonged oral prednisone taper over 11 weeks. She achieved durable response over 6 months without further pembrolizumab and was successfully rechallenged without recurrent high-grade immunotoxicity. Read More

View Article and Full-Text PDF
February 2021

IgG4-related kidney disease with systemic Epstein-Barr virus infection: A case report.

Clin Nephrol 2021 Feb 24. Epub 2021 Feb 24.

IgG4-related disease (IgG4-RD) is a newly recognized multi-organ fibro-inflammatory condition with characteristic histopathological findings of increased IgG4+ plasma cells in tissue and usually with increased IgG4 serum levels. Kidney involvement in IgG4-RD has been well described since 2006. Epstein-Barr virus (EBV) has reportedly been associated with nodal IgG4-RD, but not in extra-nodal disease. Read More

View Article and Full-Text PDF
February 2021

ROBUST: A Phase III Study of Lenalidomide Plus R-CHOP Versus Placebo Plus R-CHOP in Previously Untreated Patients With ABC-Type Diffuse Large B-Cell Lymphoma.

J Clin Oncol 2021 Feb 23:JCO2001366. Epub 2021 Feb 23.

Division of Hematology, A.O.U. Città della Salute e della Scienza Hospital and University, Torino, Italy.

Purpose: Patients with the activated B-cell-like (ABC) subtype of diffuse large B-cell lymphoma (DLBCL) historically showed inferior survival with standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Phase II studies demonstrated that adding the immunomodulatory agent lenalidomide to R-CHOP improved outcomes in ABC-type DLBCL. The goal of the global, phase III ROBUST study was to compare lenalidomide plus R-CHOP (R2-CHOP) with placebo/R-CHOP in previously untreated, ABC-type DLBCL. Read More

View Article and Full-Text PDF
February 2021

Chlorambucil combination therapy in refractory serpiginous choroiditis: A cure?

Am J Ophthalmol Case Rep 2021 Mar 30;21:101014. Epub 2021 Jan 30.

Massachusetts Eye Research and Surgery Institution, Waltham, MA, United States.

Purpose: To find a remedy for serpiginous choroiditis refractory to oral prednisone and chlorambucil treatment.

Observations: Eight eyes of four patients (all female) with advanced macular involvement secondary to serpiginous choroiditis were included in the study. The average age of the patients was 45. Read More

View Article and Full-Text PDF

Metachronous primary cancer of the tongue and malignant lymphoma of the small intestine: A case report.

Medicine (Baltimore) 2021 Feb;100(7):e24806

Department of Oral and Maxillofacial Surgery, Iwata City Hospital, Iwata.

Rationale: Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma. Read More

View Article and Full-Text PDF
February 2021