Acute anterior uveitis and conjunctivitis following Yersinia infection in children
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Yersinia infection can cause ocular inflammation, including uveitis and conjunctivitis, in children. This is particularly common in HLA-B27 positive children over 10, often alongside reactive arthritis.
Area of Science:
- Ophthalmology
- Pediatrics
- Rheumatology
- Infectious Diseases
Background:
- Yersinia infections are known triggers for reactive arthritis.
- Ocular manifestations in children associated with Yersinia are less commonly reported.
- The role of HLA-B27 in Yersinia-induced ocular inflammation requires further elucidation.
Purpose of the Study:
- To characterize ocular inflammation in children following Yersinia infection.
- To investigate the association between Yersinia infection, HLA-B27 status, and ocular/rheumatic manifestations in pediatric patients.
Main Methods:
- Retrospective case series of six children (ages 4-14) with Yersinia infection.
- Clinical assessment of ocular inflammation (uveitis, conjunctivitis) and rheumatic symptoms.
- Analysis of HLA-B27 positivity and antinuclear antibody titers.
Main Results:
- Four patients presented with acute anterior uveitis; two had bilateral involvement.
- Two patients experienced mucopurulent bilateral conjunctivitis.
- All patients exhibited reactive arthritis symptoms; one had sacroiliitis.
- All tested patients were HLA-B27 positive.
Conclusions:
- Yersinia infection can trigger reactive iritis and conjunctivitis in HLA-B27 positive children.
- Ocular inflammation, particularly uveitis, may co-occur with other HLA-B27 associated rheumatic diseases.
- Children over 10 years old with HLA-B27 positivity appear more susceptible to these manifestations.
Abstract:
We studied characteristics of ocular inflammation associated with yersinia infection in six children, three boys and three girls, ranging in age between 4 and 14 years. Four patients developed acute anterior uveitis with aqueous flare and cells, small keratic precipitates, cells in the vitreous, and occasionally with fibrinous exudates, posterior synechiae and macular edema. The uveitis was unilateral in two patients and bilateral in two. In three 10- to 14-year-old patients the uveitis resolved during corticosteroid treatment in 3 to 8 (mean 6) weeks. In a 4-year-old girl with positive antinuclear antibody titers bilateral uveitis lasted for 17 weeks. Two uveitis patients had recurrent episodes. Two patients had mucopurulent bilateral mild conjunctivitis which resolved in 3 to 5 days. All patients had symptoms of reactive arthritis and one had sacroiliitis. All tested patients were HLA-B27 positive. Our results indicate that in HLA-B27 positive children, especially after the age of 10 years, yersinia infection may occasionally trigger reactive iritis or conjunctivitis which often occur together with other HLA-B27 associated rheumatic diseases.