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Parthopratim Dutta Majumder¹, Mamta Agarwal², Anitha Manoharan¹

¹Uvea Services, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, India.

Ocular immunology and inflammation

|December 21, 2023

概括

本案例研究突出了一个患者最初治疗传染性硬化症,后来被诊断出具有多炎 (GPA) 的颗粒瘤病. 早期的ANCA测试可能会错过GPA,强调在排除感染时需要免疫抑制.

科学领域:

眼科医生眼科眼科
类风湿病学类风湿病学
传染性疾病传染性疾病

背景情况:

结核炎可能会出现视力威胁的并发症,如视网膜脱落.
区分传染性硬化症和自身免疫原因对于适当的管理至关重要.
带有多管炎 (GPA) 的粒状瘤炎是一种罕见的自身免疫性血管炎,可以影响眼睛.

研究的目的:

报告一例双侧硬化炎的病例,最初被误诊为传染病.
为了说明区分感染性硬化症与GPA的诊断挑战.
强调在耐火性硬化炎中考虑自身免疫病因的重要性.

主要方法:

一个单一患者病例的回顾性图表审查.
临床检查,微生物学研究 (皮活检,PCR) 和组织病理学分析.
风湿学评估包括抗中性粒细胞质自身抗体 (ANCA) 测试.

主要成果:

患者最初出现了硬化症和视网膜脱落,尽管有负面培养,但被视为传染性.
受到影响的眼睛的化揭示了斯塔菲洛科克斯arlettae感染.
随后在对侧眼中发生死性硬化症导致ANCA阳性,并诊断出GPA.

结论:

视网膜脱落可能是硬化症的预兆,包括与GPA相关的症状.
早期的ANCA测试可能在GPA中呈阴性,使诊断复杂化.
在感染被排除在外的视网膜脱落性硬化病例中,应考虑高剂量免疫抑制,而不是手术干预.

关键词:

排泄性视网膜脱落,导致视网膜脱落.带有多阳性炎的颗粒瘤症.感染性硬化症感染性硬化症这就是Rituximab.脊椎组织活检脊椎组织活检

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