Detaillierte Beitrags-Information
| Beitragstitel | Sudden onset of anterior uveitis during chemotherapy of Cytosine Arabinoside |
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| Präsentationsform | ePoster |
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| Abstract-Text |
Sudden onset of anterior uveitis during chemotherapy of Cytosine Arabinoside Céline N. I. Häller (1), Yalda Sadeghi(1), Malik Benmachiche (2), Y.Guex-Crosier (1) (1) Service d’ophtalmologie de l’Université de Lausanne, Hôpital ophtalmique Jules-Gonin (2) Service de médecine interne, CHUV, UNIL Purpose We report one case of uveitis secondary to a treatment with Cytosine Arabinoside (Ara-C) Method A 49 year-old man diagnosed with myelodysplasic syndrome with excess of blasts, received a standard treatment including high dose of Ara-C. Two days after finishing the second cycle of Ara-C, the patient complains of ocular pain and tearing in both eyes. Results Clinical examination showed a normal visual acuitiy and intraocular pressure OU. The biomicroscopic examination highlighted a superficial punctate keratitis OU, as well as bilateral acute non granulomatous normotensive anterior uveitis, with posterior synechia OD. Topical treatment with prednisolone acetate 1% TID and Tropicamide 0,5% TID, lacrycon, and vitamin A ointment OU allowed a rapid improvement. The treatment was stopped at day 10, with no recurrence. Discussion Uveitis in the context of a treatment with Ara-C was first described in 2004 and only four cases were subsequently described in the context of the treatment for a hematopoietic malignancy (acute myeloid leukemia in three articles or large B-cell lymphoma in one article). Up to now, no article has described a precise total dose of Ara-C given before the apparition of uveitis. With our patient, we observed the apparition of a uveitis following a total dose of 1g/m2 (TD 24’000 mg). Our interpretation of this uveitis being a possible adverse effect of Ara-C is based on the short time between the introduction of Ara-C and the occurrence of uveitis, but also on the typical clinical manifestation with a bilateral uveitis, as well as a concomitant conjunctivitis and keratitis. Conclusion Based on our observations and previous case reports, we suggest that an ophthalmologist monitors the patient at least 48 hours after finishing the treatment of Ara-C, in order to introduce an adequate treatment if necessary. |