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Juvenile rheumatoid arthritis inflammatory eye disease. Parasitization of ocular leukocytes by mollicute-like
E Wirostko1, L Johnson, W Wirostko
1Edward S. Harkness Eye Institute, Columbia-Presbyterian Medical Center, New York, NY 10032.
Abstract:
Patients with juvenile rheumatoid arthritis (JRA) commonly develop serious eye disease, particularly chronic uveitis. Most chronic uveitis is idiopathic. Mollicute-like organisms (MLO) were recently reported to be a common cause of chronic uveitis. MLO are pathogenic intracellular cell wall deficient bacteria. No culture system exists for MLO. Disease diagnosis is based on detection using a transmission electron microscope. Uveitis producing MLO are detectable within parasitized intraocular leukocytes. They appear as intracytoskeletal 0.005-0.01 micron diameter filaments and undulating pleomorphic 0.01-1.0 micron tubulospherical bodies. This report describes MLO parasitized lesional leukocytes in the inflammatory eye disease of 5 patients with JRA. Our results indicate that MLO caused the uveitis of these patients. The significance of these findings and rifampin treatment of MLO disease are discussed.
Insights
Juvenile rheumatoid arthritis (JRA) patients often develop chronic uveitis. This study found Mollicute-like organisms (MLO) caused this serious eye inflammation in JRA patients, suggesting a new diagnostic and treatment approach.
Area of Science:
- Ophthalmology
- Rheumatology
- Microbiology
Background:
- Juvenile rheumatoid arthritis (JRA) frequently leads to severe ocular complications, primarily chronic uveitis.
- Most cases of chronic uveitis are idiopathic, lacking a clear causative agent.
- Mollicute-like organisms (MLO) have been recently implicated as a potential cause of chronic uveitis.
Purpose of the Study:
- To investigate the role of Mollicute-like organisms (MLO) in the pathogenesis of chronic uveitis in patients with juvenile rheumatoid arthritis (JRA).
- To describe the morphological characteristics of MLO within intraocular leukocytes in affected patients.
Main Methods:
- Diagnosis of MLO was based on detection using transmission electron microscopy.
- MLO were identified within parasitized intraocular leukocytes in the inflammatory eye disease of five JRA patients.
- Morphological analysis focused on intracytoskeletal filaments and tubulospherical bodies characteristic of MLO.
Main Results:
- MLO were detected within lesional leukocytes in the inflammatory eye disease of all five JRA patients studied.
- The morphology of the detected organisms was consistent with previously described Mollicute-like organisms.
- Findings suggest MLO are a causative agent of uveitis in these JRA patients.
Conclusions:
- Mollicute-like organisms (MLO) are identified as a likely cause of chronic uveitis in patients with juvenile rheumatoid arthritis (JRA).
- This finding has significant implications for the diagnosis and potential treatment of MLO-associated ocular inflammation.
- The study highlights the importance of considering MLO in the differential diagnosis of uveitis in JRA.