Interferon-induced central retinal vein thrombosis.

A middle-aged lady presented with sudden onset of unilateral central retinal vein thrombosis after completing 6 months course of interferon and ribavirin for chronic hepatitis C infection. She had no risk factors and all her thrombophilia workup was normal, however, she was found to be dyslipidemic which may have contributed to atherosclerosis and predispose to thrombosis. Despite anticoagulation, her visual acuity deteriorated. This case illustrates the possibility of unpredictable visual complication of interferon. Frequent eye examination should be undertaken in patients having underlying risk factors like diabetes, hypertension or dyslipidemia undergoing interferon therapy.

Adult onset still's disease with autoimmune haemolytic anaemia: two rarities in combination.

Adult Onset Still's Disease with Autoimmune Haemolytic anaemia is a rare combination, difficult to diagnose but easy to manage. Literature to date reports only two cases. Hereby, we describe first of such a case from Pakistan. A 35 year old male, known case of Autoimmune Haemolytic Anaemia, presented with the complaints of high grade fever, fatigue, myalgia, skin rash and joint pain. After thorough investigation he was diagnosed as Adult Onset Still's Disease, according to the Yamaguchi criteria, and methylprednisolone (40 mg/day) was initiated. While his fever was relieved, dramatic improvement was seen with patient joint complaints and his anaemia was also under control. Prognosis is good with regular medication, and it is necessary to educate both patient and family, to enable them to have a complete understanding of the disease and its effects on their life.