[Progressive outer retinal necrosis in a patient with malignant lymphoma].
A 29-year-old man with diffuse large B-cell lymphoma treated by radiotherapy for his relapsed lesion followed by 4 doses of weekly rituximab was admitted to our hospital with interstitial pneumonia. After steroid pulse therapy, he had contraction of the left visual field. He was diagnosed as having progressive outer retinal necrosis due to a varicella-zoster virus that was detected from the left vitreous sample. Systemic antiviral treatment failed to prevent rapid development of whole layer necrosis of the left retina. Vitrectomy with silicone oil tamponade saved his final visual acuity. This unusual event might be related to rituximab causing deterioration of humoral immunity.
Takei
Yutaka
Y
Division of Hematology and Oncology, Department of Internal Medicine, Jikei University School of Medicine.
Usui
Noriko
N
Dobashi
Nobuaki
N
Hagino
Takeshi
T
Okawa
Yutaka
Y
Takahara
Shinobu
S
Asai
Osamu
O
Kobayashi
Masayuki
M
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D058846:Antibodies, Monoclonal, Murine-Derived; D000917:Antibody Formation; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000008:administration & dosage; D018450:Disease Progression; D006563:Herpes Zoster Ophthalmicus / Q000209:etiology*; D006801:Humans; D016867:Immunocompromised Host; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000276:immunology / Q000628:therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications* / Q000276:immunology / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D015882:Retinal Necrosis Syndrome, Acute / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D000069283:Rituximab; D016896:Treatment Outcome; D014821:Vitrectomy
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000998:Antiviral Agents; D000069283:Rituximab; D008775:Methylprednisolone