ABSTRACT
PURPOSE: Since few reports had been published on the prevalence of toxocariasis in ankylosing spondylitis (AS) patients with acute non-granulomatous anterior uveitis (ANGAU), the aim of this work was to determine the presence of antibodies against Toxocara canis in AS patients with ANGAU. METHODS: Thirty-six patients (14 female and 22 male) with AS were enrolled in the study. The history of ANGAU was accepted only if diagnosed by an ophthalmologist. The detection of IgG antibodies to T. canis was determined by enzyme-linked immunosorbent assay. In addition, antibodies to Ascaris lumbricoides were also tested to verify non-specific reactions. RESULTS: The prevalence of ANGAU in the AS patients was 58% (21 / 36), and 38% (8 / 21) of the patients with ANGAU were positive for antibodies to Toxocara, while 7% (1 / 15) of AS patients without ANGAU were positive for T. canis (p = 0.038, two tails; mid-p exact). No antibodies were detected to A. lumbricoides antigens in the serum samples of patients with AS. CONCLUSIONS: These data suggest that the seroprevalence of antibodies to T. canis is high in Mexican patients with AS-associated uveitis, suggesting a chronic asymptomatic toxocariosis, which could be associated with the pathogenesis of ANGAU; however, further larger-scale studies are needed to confirm this observation.
Subject(s)
Antibodies, Anti-Idiotypic/isolation & purification , Eye Infections, Parasitic/immunology , Immunoglobulin G/immunology , Spondylitis, Ankylosing/complications , Toxocara canis/immunology , Toxocariasis/immunology , Uveitis, Anterior/immunology , Acute Disease , Adult , Aged , Animals , Enzyme-Linked Immunosorbent Assay , Eye Infections, Parasitic/complications , Eye Infections, Parasitic/parasitology , Female , Humans , Male , Middle Aged , Seroepidemiologic Studies , Spondylitis, Ankylosing/immunology , Spondylitis, Ankylosing/parasitology , Toxocara canis/isolation & purification , Toxocariasis/complications , Toxocariasis/parasitology , Uveitis, Anterior/complications , Uveitis, Anterior/parasitology , Young AdultABSTRACT
OBJECTIVE: Our aim is to describe the frequency of uveitis associated with rheumatic inflammatory autoimmune diseases (RIAD) in adult patients admitted to the Rheumatology Department at a tertiary-care hospital in Mexico City. We also describe the clinical features, seasonal distribution, treatment, and ocular complications associated with this disease. METHODS: We reviewed 1332 charts of patients with RIAD and selected those that had a diagnosis of uveitis. We obtained the following data: age, sex, type of uveitis and relationship with diagnosis of RIAD, recurrences, seasonal distribution, treatment, and residual visual deficit. RESULTS: We found 57 (4.27%) cases of uveitis in 1332 charts, including 38 men and 19 women (M:F ratio 2:1), aged 47 ± 16 years. Nongranulomatous acute anterior uveitis (NGAAU) comprised 90.52% of cases (52/57). In 64.91% of cases (37/57), uveitis preceded the diagnosis of RIAD by 12 ± 9 years, more frequently in winter (35.96%; p = NS). Uveitis was found in 40/93 patients with ankylosing spondylitis (AS), in 7/11 patients with relapsing polychondritis (RP), in 8/16 patients with Behçet's disease, in 1/16 patients with polyarteritis nodosa, and in 1/590 patients with rheumatoid arthritis (RA). Ninety-six percent of the patients were treated with steroids. Upon a mean followup of 60 days (range 7-4745 days), reduction of visual acuity (≤ 20/200) was associated with recurrence of uveitis in 3/7 cases with AS, in 4/8 cases with Behçet's disease, in 3/7 with RP, and in 1 case of uveitis and seronegative RA. CONCLUSION: NGAAU frequently precedes RIAD and is found predominately in men, with a tendency to occur in winter.
