Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome
A 37-year-old woman with a diagnosis of Behçet’s syndrome, treated with colchicine and prednisolone, maintained low disease activity for a period of 10 years, after which, she developed a new episode of anterior uveitis. A cycle of high dose systemic corticosteroids was required but the patient pres...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMC MEDIA SRL
2025-01-01
|
| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/5112 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832540862516559872 |
|---|---|
| author | Sofia Miranda Daniel Calado Joana Rua Fernando Salvador |
| author_facet | Sofia Miranda Daniel Calado Joana Rua Fernando Salvador |
| author_sort | Sofia Miranda |
| collection | DOAJ |
| description | A 37-year-old woman with a diagnosis of Behçet’s syndrome, treated with colchicine and prednisolone, maintained low disease activity for a period of 10 years, after which, she developed a new episode of anterior uveitis. A cycle of high dose systemic corticosteroids was required but the patient presented with a new flare during dose tapering. A decision to initiate a corticosteroid-sparing agent was then made, with an initially satisfactory response. However, 3 months later the ocular symptoms recurred, and a new bout of oral ulceration appeared concurrently. As a result, adalimumab was then started, but the patient presented with a sudden and severe decrease of visual acuity in her right eye 4 months later. The initial bloodwork showed no elevated inflammatory markers. A lumbar puncture showed a normal cerebrospinal fluid composition. Although these findings made it less probable that the patient’s symptoms were caused by infectious or autoimmune disease, extensive investigations directed at these possible causes were performed, with negative results. Several imaging tests were also performed, which showed no alterations. However, a sensory evoked potentials test revealed a functional compromise at the pre-chiasmatic level. An iatrogenic optic neuropathy induced by adalimumab seemed the most probable cause and a decision to suspend the treatment was made. A new cycle of high dose systemic corticosteroids consisting of three pulses of methylprednisolone followed by pred-nisolone with a quick tapering over 4 weeks was also started, with gradual improvement of visual acuity. |
| format | Article |
| id | doaj-art-261fd81b9d4344ee94890db49930498d |
| institution | Kabale University |
| issn | 2284-2594 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-261fd81b9d4344ee94890db49930498d2025-02-04T13:37:20ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-01-0110.12890/2025_0051124647Adalimumab-induced optic neuropathy in a patient with Behçet’s syndromeSofia Miranda0Daniel Calado1Joana Rua2Fernando Salvador3Internal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, PortugalInternal Medicine Department, Hospital do Divino Espírito Santo, Ponta Delgada, PortugalInternal Medicine Department, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Vila Real, PortugalInternal Medicine Department, Unidade Local de Saúde de Trás-os-Montes e Alto Douro, Vila Real, PortugalA 37-year-old woman with a diagnosis of Behçet’s syndrome, treated with colchicine and prednisolone, maintained low disease activity for a period of 10 years, after which, she developed a new episode of anterior uveitis. A cycle of high dose systemic corticosteroids was required but the patient presented with a new flare during dose tapering. A decision to initiate a corticosteroid-sparing agent was then made, with an initially satisfactory response. However, 3 months later the ocular symptoms recurred, and a new bout of oral ulceration appeared concurrently. As a result, adalimumab was then started, but the patient presented with a sudden and severe decrease of visual acuity in her right eye 4 months later. The initial bloodwork showed no elevated inflammatory markers. A lumbar puncture showed a normal cerebrospinal fluid composition. Although these findings made it less probable that the patient’s symptoms were caused by infectious or autoimmune disease, extensive investigations directed at these possible causes were performed, with negative results. Several imaging tests were also performed, which showed no alterations. However, a sensory evoked potentials test revealed a functional compromise at the pre-chiasmatic level. An iatrogenic optic neuropathy induced by adalimumab seemed the most probable cause and a decision to suspend the treatment was made. A new cycle of high dose systemic corticosteroids consisting of three pulses of methylprednisolone followed by pred-nisolone with a quick tapering over 4 weeks was also started, with gradual improvement of visual acuity.https://www.ejcrim.com/index.php/EJCRIM/article/view/5112adalimumaboptic neuropathy |
| spellingShingle | Sofia Miranda Daniel Calado Joana Rua Fernando Salvador Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome European Journal of Case Reports in Internal Medicine adalimumab optic neuropathy |
| title | Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome |
| title_full | Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome |
| title_fullStr | Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome |
| title_full_unstemmed | Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome |
| title_short | Adalimumab-induced optic neuropathy in a patient with Behçet’s syndrome |
| title_sort | adalimumab induced optic neuropathy in a patient with behcet s syndrome |
| topic | adalimumab optic neuropathy |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/5112 |
| work_keys_str_mv | AT sofiamiranda adalimumabinducedopticneuropathyinapatientwithbehcetssyndrome AT danielcalado adalimumabinducedopticneuropathyinapatientwithbehcetssyndrome AT joanarua adalimumabinducedopticneuropathyinapatientwithbehcetssyndrome AT fernandosalvador adalimumabinducedopticneuropathyinapatientwithbehcetssyndrome |