RESUMO
Acute multifocal placoid pigment epitheliopathy (AMPPE) is a rare inflammatory vasculitis of the choroid. Despite primarily being a disorder of the eye, a number of extra-ophthalmological features have been described in AMPPE and may accompany the visual disturbances. Such patients may be admitted under the care of physicians for evaluation of a systemic illness. We report AMPPE occurring in a 37-year-old man in his thirties admitted with a flu-like illness, erythema nodosum, visual disturbances and raised inflammatory markers. Conditions such as bacterial endocarditis and vasculitis, were considered before a diagnosis of AMPPE was made. The case illustrates how AMPPE can be a diagnostic dilemma, particularly when associated with extra-ophthalmological features. The epidemiology, clinical features, diagnosis and therapy of AMPPE are also discussed.
Assuntos
Coriorretinite/diagnóstico , Eritema Nodoso/diagnóstico , Eritema Nodoso/patologia , Epitélio Pigmentado Ocular/anormalidades , Adulto , Coriorretinite/patologia , Angiofluoresceinografia/métodos , Humanos , Inflamação , Influenza Humana/diagnóstico , Masculino , Doenças Retinianas/complicações , Doenças Retinianas/diagnóstico , Transtornos da Visão/complicações , Transtornos da Visão/diagnósticoRESUMO
We report an unusual case of bilateral chronic conjunctivitis and corneal scarring in a boy with X-linked hypogammaglobulinaemia (XLH) who did not respond to the usual antibacterial and antiviral therapy. An immunofluorescence test for Chlamydia trachomatis from an eye swab was strongly positive. Within days of commencement of local and systemic tetracycline therapy, he showed marked improvement. Since conjunctival follicle formation, which depends on the presence of a B-cell population, may not occur in XLH, clinical examination in chlamydia conjunctivitis may be misleading and lead to a delay in diagnosis and treatment with resulting corneal complications, unless laboratory evidence of chlamydia infection is specifically sought.
Assuntos
Agamaglobulinemia/genética , Infecções por Chlamydia/complicações , Chlamydia trachomatis/isolamento & purificação , Conjuntivite Bacteriana/microbiologia , Lesões da Córnea , Ligação Genética , Agamaglobulinemia/complicações , Criança , Doença Crônica , Cicatriz/etiologia , Conjuntivite Bacteriana/complicações , Humanos , Masculino , Cromossomo XRESUMO
The case of a 68 year old woman with a sudden onset of visual loss in the left eye is reported. Carotid duplex scanning revealed a 50-75% stenosis of the left internal carotid artery, with a floating tail of clot extending into the lumen of the artery. Emergency carotid endarterectomy, removing the plaque with the attached thrombus, was performed.
