Severe bilateral necrotising retinitis caused by Toxoplasma gondii in a patient with systemic lupus erythematosus and diabetes mellitus
| Autor: | M I S Duarte, Ruth Miyuki Santo, M M Shinzato, Joyce Hisae Yamamoto, Y Nakashima, D I Boletti, Carlos Eduardo Hirata, Jorge Kalil, T S Okay, Edilberto Olivalves |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_specialty
Letter Systemic lupus erythematosus Visual acuity genetic structures business.industry medicine.medical_treatment Posterior pole Type 2 Diabetes Mellitus Retinitis Immunosuppression Fundus (eye) medicine.disease eye diseases Sensory Systems Surgery Cellular and Molecular Neuroscience Ophthalmology medicine sense organs Acute retinal necrosis medicine.symptom business |
| Zdroj: | British Journal of Ophthalmology. 87:651-652 |
| ISSN: | 0007-1161 |
| DOI: | 10.1136/bjo.87.5.651 |
| Popis: | Ocular toxoplasmosis may be remarkably atypical in situations of evident immunosuppression such as acquired immunodeficiency syndrome, malignancy, and use of chronic immunosuppressive drug therapy.1 Aggressive forms in immunocompetent hosts are very rare.2,3 We present a case of severe, bilateral necrotising retinitis by Toxoplasma gondii initially misdiagnosed as an acute retinal necrosis (ARN) syndrome, in a patient with systemic lupus erythematosus (SLE) and diabetes mellitus type 2, who was taking medium dose prednisone. A 47 year old woman reported a 3 month history of rapid visual loss in the right eye followed by a decrease in her left eye vision 2 months later. Twenty days before the onset of ocular symptoms the patient had a seizure. Her medical history showed a SLE,4 with an active lupus central nervous system disease controlled with prednisone (0.5 mg/kg/day), and type 2 diabetes mellitus. At her first visit to our service, visual acuity was hand movements in both eyes. Slit lamp examination showed 3+ aqueous cells and flare, and 2+ anterior vitreous cells in both eyes. The fundus showed a 2+ vitreous haze and almost 360° creamy white necrotising retinitis extending from the ora serrata to the posterior pole, including the macula in both eyes (Fig 1A and B). Thumbprint patches at the border between necrotic and scanty normal retina could be observed, and also diffuse vascular attenuation. Figure 1 (A) Fundus appearance of … |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|