ABSTRACT
CASE SUMMARY: We present the case of a 50 year old male patient being treated for chronic myeloid leukemia by the tyrosine kinase inhibitor, Ponatinib. After 3 months of treatment, he developed a sight-threatening granulomatous panuveitis in both eyes, with choroidal effusions and neurosensory retinal detachments. Except for a positive interferon-gamma release assay suggesting previous Tuberculosis exposure, all uveitis investigations were normal. Discontinuation of the suspected causative drug led to resolution of signs and a consequent improvement in visual acuity. CONCLUSION: Ponatinib use may be associated with with a uveitic phenotype that is reminiscent of Harada's disease. We compare and contrast this rare ocular phenomenon with Vogt-Koyanagi-Harada syndrome and discuss a possible immunological basis.
Subject(s)
Choroidal Effusions , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Panuveitis , Retinal Detachment , Uveitis , Uveomeningoencephalitic Syndrome , Humans , Imidazoles , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Male , Panuveitis/chemically induced , Panuveitis/diagnosis , Panuveitis/drug therapy , Protein Kinase Inhibitors/therapeutic use , Pyridazines , Retinal Detachment/chemically induced , Retinal Detachment/diagnosis , Retinal Detachment/drug therapy , Uveitis/complications , Uveomeningoencephalitic Syndrome/diagnosisABSTRACT
PURPOSE: To raise awareness of the importance of prompt and appropriate imaging in patients presenting with signs and symptoms suggestive of idiopathic intracranial hypertension. METHODS: Case report with diagnostic tests and discussion of management options. RESULTS: A 15-year-old girl presenting with bilateral optic disc swelling was noted to have extensive thrombosis of intracerebral venous sinuses with the clot extending along the internal jugular vein as inferior as the root of the neck demonstrable on magnetic resonance venography. CONCLUSIONS: Ophthalmologists should be vigilant in obtaining appropriate imaging in cases of optic disc swelling.
Subject(s)
Cerebral Veins/drug effects , Contraceptives, Oral, Combined/adverse effects , Ethinyl Estradiol-Norgestrel Combination/adverse effects , Papilledema/chemically induced , Sinus Thrombosis, Intracranial/chemically induced , Adolescent , Anticoagulants/therapeutic use , Female , Humans , Magnetic Resonance Imaging , Papilledema/diagnosis , Papilledema/drug therapy , Phlebography , Sinus Thrombosis, Intracranial/diagnosis , Sinus Thrombosis, Intracranial/drug therapy , Warfarin/therapeutic useABSTRACT
PURPOSE: To highlight the diversity of clinical presentations with tubercular uveitis in a nonendemic setting, and discuss the diagnostic approach and an effective treatment. METHOD: Descriptive case series. RESULTS: A total of 12 cases of varied presentations of tubercular uveitis diagnosed over a period of 1 year of which six cases are described in detail. Presentations included choroidal tuberculomas, multifocal choroiditis, recurrent granulomatous uveitis, panuveitis with cystoid macular oedema, and serpiginous choroiditis. All cases had a chronic or recurrent course and responded very well to antitubercular treatment. Diagnosis was mainly assisted by positive tuberculin testing. CONCLUSION: A high index of suspicion helps diagnose ocular tuberculosis in areas of low prevalence of the disease. It forms part of the differential diagnosis of any chronic or recurrent uveitis, especially in an at-risk patient. Antitubercular treatment seems highly effective.
Subject(s)
Tuberculosis, Ocular/diagnosis , Uveitis/microbiology , Adolescent , Adult , Aged , Antitubercular Agents/therapeutic use , Choroiditis/drug therapy , Choroiditis/microbiology , Chronic Disease , Female , Humans , Male , Middle Aged , Panuveitis/drug therapy , Panuveitis/microbiology , Recurrence , Retrospective Studies , Tuberculosis, Ocular/drug therapy , Uveitis/drug therapySubject(s)
Glaucoma/etiology , Thrombophilia/complications , Adult , Aged , Female , Humans , Male , Middle Aged , Risk FactorsABSTRACT
An orbital embryonal rhabdomyosarcoma is reported. The diagnosis was delayed by several weeks due to a concurrent history of repeated trauma.
