Rituximab, Intravitreal Bevacizumab and Laser Photocoagulation for Treatment of Macrophage Activation Syndrome and Retinal Vasculitis in Lupus: A Case Report

Systemic lupus erythematosus (SLE) most commonly manifests as mild to moderate disease with severe manifestations such as diffuse alveolar hemorrhage, central nervous system vasculitis, macrophage activation syndrome (MAS) or retinal vasculitis (RV) with visual disturbances occurring in a significan...

Full description

Saved in:
Bibliographic Details
Published in:International journal of molecular sciences 2023-02, Vol.24 (3), p.2594
Main Authors: Ikić Matijašević, Marina, Kilić, Paula, Ikić, Lucija, Galić, Iva, Brzović Šarić, Vlatka, Galić, Edvard
Format: Article
Language:English
Subjects:
Alveoli
Anemia
Bevacizumab
Bevacizumab - therapeutic use
Bone marrow
Case Report
Case reports
Cell activation
Central nervous system
Chronic conditions
Disease
Glucocorticoids
Health services
hemophagocytic lymphohistiocytosis
Hemorrhage
Humans
Immunotherapy
Laboratories
Lasers
Leukopenia
Light Coagulation - adverse effects
Lupus
Lupus Erythematosus, Systemic - drug therapy
macrophage activation syndrome
Macrophage Activation Syndrome - complications
Macrophages
Medical imaging
Monoclonal antibodies
Mortality
Remission (Medicine)
Retina
retinal vasculitis
Retinal Vasculitis - drug therapy
Retinal Vasculitis - etiology
Rheumatology
Rituximab
Rituximab - therapeutic use
Systemic lupus erythematosus
Thrombocytopenia
Vascular endothelial growth factor
Vasculitis
Vision Disorders
Visual acuity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Systemic lupus erythematosus (SLE) most commonly manifests as mild to moderate disease with severe manifestations such as diffuse alveolar hemorrhage, central nervous system vasculitis, macrophage activation syndrome (MAS) or retinal vasculitis (RV) with visual disturbances occurring in a significantly smaller proportion of patients, most of whom have a poor outcome. Macrophage activation syndrome and RV are insufficiently early and rarely recognized presentations of lupus-consequently there are still no treatment recommendations. Here we present the course of diagnosis and treatment of a patient with an SLE flare that resulted in both life-threatening disease (MAS) and vision-threatening disease (RV). The patient was successfully treated with systemic immunosuppressives, a high dose of glucocorticoids and rituximab (RTX), in parallel with intraocular therapy, intravitreal bevacizumab (BEV) and laser photocoagulation.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms24032594