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Uveitis as an Open Window to Systemic Inflammatory Diseases.

Thomas El Jammal1, Olivier Loria2,3, Yvan Jamilloux1

  • 1Department of Internal Medicine, Hôpital de la Croix-Rousse, Université Claude Bernard Lyon I, 69004 Lyon, France.

Journal of Clinical Medicine
|January 20, 2021
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Summary

Systemic inflammatory diseases like Spondyloarthritis (Spa), Behçet

Keywords:
Behçet’s diseaseHLA-B27 associated uveitissarcoidosisspondyloarthritisuveitis

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Area of Science:

  • Rheumatology
  • Ophthalmology
  • Internal Medicine

Background:

  • Spondyloarthritis (Spa), Behçet's disease (BD), and sarcoidosis are systemic inflammatory diseases with potential ocular involvement, particularly uveitis.
  • Unexplained uveitis often requires referral to internal medicine for diagnosing underlying systemic conditions.

Purpose of the Study:

  • To describe diagnostic approaches and outcomes for patients with unexplained uveitis referred for systemic evaluation.
  • To highlight the importance of early diagnosis and multidisciplinary care for sight-threatening inflammatory diseases.

Main Methods:

  • Retrospective analysis of 75 patients diagnosed with Spa, BD, or sarcoidosis over two years.
  • Utilized physical examination, laboratory tests, and advanced imaging (MRI, CT, PET-CT) for diagnosis.
  • Specific screening strategies included Human Leukocyte Antigen (HLA)-B27 and sacroiliac MRI for Spa.

Main Results:

  • Sarcoidosis was the most frequent diagnosis (n=46), followed by Spa (n=20) and BD (n=9).
  • Significant diagnostic delays were observed for Spa-associated uveitis.
  • BD-associated uveitis typically presented as panuveitis and retinal vasculitis in young adults.
  • Advanced imaging aided in diagnosing sarcoidosis, especially in elderly patients.

Conclusions:

  • A multidisciplinary approach is crucial for prompt diagnosis of systemic inflammatory diseases presenting with uveitis.
  • Early detection and management of Spa, BD, and sarcoidosis are essential to prevent vision loss and systemic complications.