A few risk factors that may have predisposed our patient to the development of NE were her supratherapeutic tacrolimus level at admission, treatment with an antimetabolite
(mycophenolate), treatment with other myelosuppressive medications such as prophylactic antibiotics, and elevated Epstein-Barr viral load.
Other contributing mediators include antimetabolites
, such as azathioprine, and anti-TNF-alpha drugs that are key to Crohn's maintenance and perineal fistula management .
Table 1 Classification of uveitis Type of uveitis Location State of inflammation Anterior Iris Iritis Ciliary body Anterior cyclitis Iris and ciliary body Iridocyclitis Intermediate Vitreous Vitritis Hyalitis Pars planitis Posterior Choroid Choroiditis Retina Retinitis Neuroretinitis Choroid and retina Chorioretinitis Retinochoroiditis Pan-uveitis All of the above All of the above Table 2 Prednisolone acetate 1% Prednisolone sodium phosphate 0.1-0.5% Fluorometholone 0.1% Rimexolone 1% Loteprednol etabonate 0.5% Table 3 Immunosuppressive drugs Table 3 Class Examples Antimetabolites
Azathioprine Methotrexate Mycophenolate mofetil Alkylating agents Cyclophosphamide Chlorambucil Antibiotics Cyclosporine Tacromimus Rapamycin Dapsone Adjuvants Bromocriptine Ketoconazole Colchicine
Glaucoma filtration surgery in pregnant patients may be at relatively higher risk of failure because of young age, physiological changes during pregnancy, and contraindicated antimetabolite
Apoptotic enteropathy caused by antimetabolites
and TNF-alpha antagonists.
Besides corticosteroids, long-term treatment options for the treatment of JIA-associated uveitis include antimetabolites
, alkylating agents and biologic agents.
Among potential combination partners are antimetabolites
combined with other chemotherapeutic drugs or radiotherapy, to selectively enhance the antitumor activity and provide a selective protection of normal tissues (Bergman et al.
Some important substances such as hormones and antimetabolites
are also released by these microorganisms in the rhizosphere which play pivotal role in boosting the plant growth.
Modufolin (chemical name [6R]-5,10- methylenetetrahydrofolate), is a novel folate-based compound developed to increase the efficacy and reduce the side effects of antimetabolites
used in cancer treatment.
However similar results may not be obtainable in higher risk eyes without the use of antimetabolites
as the only demonstrable risk factor for failure in our patients was the prior use of topical medications.
Elgemeie, "Thioguanine, mercaptopurine: their analogs and nucleosides as antimetabolites
," Current Pharmaceutical Design, vol.
Surgeries that involve manipulation of the limbus and application of topical antimetabolites
, used during glaucoma surgeries, are identified as keratopathy deteriorating factors .