When Dermatomyositis Patient Has Blurring of Vision – What Goes Wrong?
CMV Retinitis in Dermatomyositis
Abstract
Cytomegalovirus (CMV) retinitis occurs predominantly in Human Immunodeficiency Virus (HIV) -infected patients. It was also reported in HIV-seronegative patients with systemic autoimmune disorder requiring systemic immunosuppression, organ or bone marrow transplantation, haematological or breast malignancy receiving chemotherapy, ocular diseases following intraocular or periocular corticosteroid injection, diabetes mellitus and Good syndrome. However, CMV retinitis in patients with concurrent dermatomyositis and malignancy has not been previously reported. It has not been reported in cancer other than haematological or breast malignancy, or in cancer patient prior to chemotherapy. We report a case of 40-year-old HIV-seronegative woman with underlying dermatomyositis and lung malignancy who developed right CMV retinitis which relapsed after recommencement of immunosuppressant. Both episodes of CMV retinitis were successfully treated after taken her immunocompromised state into consideration.
Keywords :
Cytomegalovirus retinitis,
dermatomyositis,
lung neoplasms,
Abstrak
Cytomegalovirus (CMV) Retinitis merupakan penyakit yang berlaku pada pesakit yang menghidapi Human Immunodeficiency Virus (HIV) terutamanya. Ia juga dilaporkan pada pesakit tanpa HIV, contohnya pesakit menghidapi gangguan autoimun yang memerlukan immunosuppresif, pesakit menjalani pemindahan organ atau sumsum tulang, pesakit kanser darah atau payudara yang menerima kemoterapi, penyakit mata berikutan suntikan kortikosteroid intraokular atau periokular, kencing manis dan Good sindrom. Walau bagaimanapun, kes CMV retinitis dalam pesakit yang menghidapi dermatomyositis dan kanser pada masa yang sama tidak pernah dilaporkan sebelum ini. Ia juga tidak dilaporkan dalam kanser selain kanser darah atau payudara, atau pesakit kanser sebelum menerima rawatan kemoterapi. Kami melaporkan kes CMV retinitis dalam seorang wanita tanpa HIV berusia 40 tahun yang menghidapi dermatomyositis dan kanser paru-paru, di mana CMV retinitisnya kembali apabila immunosuppresif dimula semula. Kedua-dua episod CMV retinitis telah berjaya dirawat selepas mengambil kira keadaan keimunannya.
Kata Kunci :
Cytomegalovirus Retinitis,
dermatomyositis,
kanser paru-paru,
Correspondance Address
Christina Ng Wei Khee. Department of Ophthalmology, Hospital Selayang, Lebuhraya Selayang-Kepong, 68100 Batu Caves, Selangor, Malaysia/ Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +603-61263333 Fax: +603-61371652 E-mail: christinangwk@gmail.com
