Cytomegalovirus Retinitis in a Patient Taking Upadacitinib: A Case Report

Upadacitinib is a relatively new drug used to treat autoimmune diseases. However, patients treated with upadacitinib may develop infections. We report a case of cytomegalovirus (CMV) retinitis that developed during upadacitinib administration. A 79-year-old woman presented with progressively decreas...

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Published inCurēus (Palo Alto, CA) Vol. 15; no. 11; p. e48337
Main Authors Hirai, Hiromasa, Akai, Yasuhiro, Ogata, Nahoko, Ueda, Tetsuo
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 05.11.2023
Subjects
Autoimmune diseases
Case reports
Cornea
Cytomegalovirus
Edema
Hemorrhage
Infections
Inflammation
Kinases
Leukocytes
Patients
Pneumonia
Rheumatoid arthritis
Severe acute respiratory syndrome coronavirus 2
Silicones
Steroids
Visual acuity
upadacitinib
cytomegalovirus (cmv)
jak inhibitor
rheumatoid arthritis
cytomegalovirus retinitis
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Summary:Upadacitinib is a relatively new drug used to treat autoimmune diseases. However, patients treated with upadacitinib may develop infections. We report a case of cytomegalovirus (CMV) retinitis that developed during upadacitinib administration. A 79-year-old woman presented with progressively decreasing vision in both eyes. Her decimal best-corrected visual acuity (BCVA) was 0.2 in the right and 0.01 in the left eye. The patient was taking upadacitinib for one year. Fundus examination revealed vitreous opacities and extensive white retinal lesions with hemorrhage in both eyes. CMV was detected in the anterior aqueous humor, vitreous humor, and blood samples. We diagnosed her with panuveitis and CMV retinitis, performed a vitrectomy in both eyes, and administered intravenous ganciclovir and steroids. After treatment, her BCVA improved to 0.6 in the right and 0.1 in the left eye. Ophthalmologists and physicians should be aware of CMV infections in patients being treated with upadacitinib.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.48337