Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This c...Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.展开更多
BACKGROUND Gastric neuroendocrine carcinomas(NECs)exhibit aggressive features,such as rapid growth,higher rate of metastasis,and a generally unfavorable prognosis compared to gastric adenocarcinoma.As a result,therape...BACKGROUND Gastric neuroendocrine carcinomas(NECs)exhibit aggressive features,such as rapid growth,higher rate of metastasis,and a generally unfavorable prognosis compared to gastric adenocarcinoma.As a result,therapeutic options for NECs remain limited,contributing to the poor prognosis of patients.Immunotherapy has emerged as a promising treatment strategy and demonstrated the potential to partially improve the survival and prognosis of patients with NECs.Nevertheless,the unique clinical response termed pseudoprogression(PsP)has garnered considerable attention in the context of immunotherapy.CASE SUMMARY Presented here is a case of NEC recurrence five and a half months after radical gastric surgery.The 45-year-old male patient underwent combination treatment involving a PD-1 blocker and tyrosine kinase inhibitors and encountered two instances of PsP during treatment.The patient ultimately achieved a durable treatment response without altering his treatment regimens,resulting in a substantial therapeutic benefit.CONCLUSION This case report aimed to provide the authors’experience with the diagnosis of PsP and treatment strategies for PsP in ongoing immunotherapy.展开更多
文摘Background: Thyroid Eye Disease (TED) is known to alter tissues of the orbital cavity, including the optic nerve. However, its effect on measured global Retinal Nerve Fiber Layer (gRNFL) is not well elucidated. This case evaluates the effect of teprotumumab on gRNFL in a patient with moderate TED. Observations: A 60-year-old female with controlled ocular hypertension and moderate TED received 8 standard IV teprotumumab infusions. Comprehensive ocular evaluations were performed pre-, during-, and post-treatment. Bilateral gRNFL thickness decreased (10 m OD;12 m OS) at 4 months post-treatment start, persisting at 8 months, but recovered at 20 months. Conclusions and Importance: Teprotumumab treatment in patients with TED led to a transient bilateral decrease in gRNFL thickness, which was restored to baseline levels with no adverse events reported. Monitoring gRNFL changes in teprotumumab-treated patients is crucial as gRNFL thinning indicates retinal ganglion cell damage. Teprotumumabs ability to dampen the IGF-IR inflammatory cascade may have reduced retinal inflammation, leading to recovery.
基金Wu Jieping Medical Foundation,No.320.6750.2021-02-113.
文摘BACKGROUND Gastric neuroendocrine carcinomas(NECs)exhibit aggressive features,such as rapid growth,higher rate of metastasis,and a generally unfavorable prognosis compared to gastric adenocarcinoma.As a result,therapeutic options for NECs remain limited,contributing to the poor prognosis of patients.Immunotherapy has emerged as a promising treatment strategy and demonstrated the potential to partially improve the survival and prognosis of patients with NECs.Nevertheless,the unique clinical response termed pseudoprogression(PsP)has garnered considerable attention in the context of immunotherapy.CASE SUMMARY Presented here is a case of NEC recurrence five and a half months after radical gastric surgery.The 45-year-old male patient underwent combination treatment involving a PD-1 blocker and tyrosine kinase inhibitors and encountered two instances of PsP during treatment.The patient ultimately achieved a durable treatment response without altering his treatment regimens,resulting in a substantial therapeutic benefit.CONCLUSION This case report aimed to provide the authors’experience with the diagnosis of PsP and treatment strategies for PsP in ongoing immunotherapy.
