When systemic lupus erythematosus affects vision: a rare presentation of this condition
| Autor: | Tiago Gama Ramires, Luísa Vieira, Nuno Riso, Maria Francisca Moraes-Fontes |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anti-nuclear antibody Fever Azathioprine 03 medical and health sciences Young Adult 0302 clinical medicine Blurred vision Retinal Diseases medicine Humans Lupus Erythematosus Systemic Tomography Optical skin and connective tissue diseases 030203 arthritis & rheumatology Systemic lupus erythematosus business.industry Angiography Hydroxychloroquine General Medicine Retinal vascular tortuosity medicine.disease Dermatology Arthralgia Reminder of Important Clinical Lesson 030221 ophthalmology & optometry Female medicine.symptom Low Complement business Retinopathy medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 23-year-old woman with fever, oral ulcers, arthalgias and weight loss of 2-week duration suddenly developed blurred vision, with reduced visual acuity, cotton wool exudates and retinal vascular tortuosity. Laboratory testing revealed anaemia, lymphopaenia, positive antinuclear antibody and high anti-dsDNA antibody titre with low complement components. There was no evidence of infection, clinching the diagnosis of lupus retinopathy. Steroid therapy alone was highly effective and was also accompanied by a normalisation of haemoglobin and lymphocyte counts, after which azathioprine was added. Hydroxychloroquine was introduced after resolution of retinal changes. Immunosuppressive therapy was progressively tapered over the course of 12 months and then discontinued, and the patient remains in remission 48 months after the initial presentation. Our patient exemplifies a very rare manifestation of systemic lupus erythematosus. We emphasise the importance of its early detection and complexity of treatment in order to reduce visual morbidity. |
| Databáze: | OpenAIRE |
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