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Very severe HLA B27-associated panuveitis mimicking endophthalmitis: a case series

Chintan Sanghvi1, Karl Mercieca, Nicholas P Jones

  • 1Manchester Royal Eye Hospital, Manchester, UK. casanghvi1@googlemail.com

Ocular Immunology and Inflammation
|April 8, 2010
PubMed
Abstract

Insights

Severe HLA B27-associated uveitis can mimic infection, presenting as hyperacute panuveitis. This rare condition requires prompt diagnosis and intensive management, often including immunosuppression and cataract surgery.

Area of Science:

  • Ophthalmology
  • Immunology
  • Genetics

Background:

  • Human Leukocyte Antigen B27 (HLA B27) is associated with various inflammatory conditions.
  • Uveitis, particularly HLA B27-associated uveitis, can present with diverse clinical manifestations.

Observation:

  • This study reports rare cases of very severe, hyperacute HLA B27-associated panuveitis.
  • These cases mimicked infective endophthalmitis, posing diagnostic and management challenges.

Findings:

  • Four patients presented with severe panuveitis, visual acuity below 6/60, and poor fundal views.
  • All cases required high-dose corticosteroids, two needed immunosuppression, and all eventually underwent cataract extraction.
  • Final visual acuities ranged from 6/12 to 6/6, indicating potential for visual recovery with appropriate treatment.

Implications:

  • HLA B27-associated uveitis can manifest with extreme severity and panuveitis.
  • Early recognition and aggressive management are crucial for preventing complications like cataract and preserving vision.
  • Differentiating from infective endophthalmitis is critical for appropriate therapeutic decisions.

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