Optička neuropatija izazvana takrolimusom

  • Lepša Žorić University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia
  • Aleksandra Ilić University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia
  • Emina Čolak University Clinical Center of Serbia, Institute of Medical Biochemistry, Belgrade, Serbia
  • Miloš Mirković University of Priština, Faculty of Medicine, Ophthalmology Department, Kosovska Mitrovica, Serbia
  • Jelica Pantelić University Clinical Center of Serbia, Institute of Eye Diseases, Belgrade, Serbia
  • Dijana Mirić University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia
  • Bojana Kisić University of Priština, Faculty of Medicine, Institute of Medical Biochemistry, Kosovska Mitrovica, Serbia
DOI: https://doi.org/10.2298/VSP201126004Z
Ključne reči: lekovi, neželjeni efekti i neželjene reakcije, takrolimus, neuropatija, optička, toksična, lečenje, ishod

Sažetak


Uvod. Takrolimus (fujimycin, FK506) je potentan imunosupresivni lek čija upotreba je u porastu. Obično se koristi u prevenciji odbacivanja transplantiranih organa. Njegova primena je dragocena, iako, poput drugih imunosupresivnih lekova, ima i neželjena dejstva. Jedno od takvih dejstava je optička neuropatija. Prikaz bolesnika. Bolesnik muškog pola, star 47 godina, koji je zbog transplantiranog bubrega primao takrolimus devet godina, razvio je bezbolni gubitak vida na oba oka, subakutnog toka. On je detaljno ispitan na moguće uzroke optičkih neuropatija i druge moguće uzroke gubitka vida. Nakon isključenja drugih mogućih uzroka, postavljena mu je dijagnoza toksične optičke neuropatije. Nadležni nefrolog je izmenio terapiju i uveo ciklosporin, ali vid se samo diskretno poboljšao. Zaključak. Toksične optičke neuropatije se javljaju u svakodnevnoj oftalmološkoj praksi, ali se na njih retko posumnja. Postavljanje dijagnoze može biti zahtevno, posebno u slučaju lekova i suspstanci čije moguće toksično dejstvo na očni nerv nije šire poznato. Za razliku od ostalih neželjenih dejstava takrolimusa na nervni sistem, toksična optička neuropatija može izazvati značajan i trajan gubitak vida.

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Objavljeno
2022/07/13
Broj časopisa
Vol. 79 Br. 6 (2022): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika