Autoimmune retinopathy associated with systemic lupus erythematosus: A diagnostic dilemma

Autor: Wadakarn Wuthisiri, Yu-Hung Lai, Jenina Capasso, Martin Blidner, David Salz, Erik Kruger, Alex V Levin
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Taiwan Journal of Ophthalmology, Vol 7, Iss 3, Pp 172-176 (2017)
Druh dokumentu: article
ISSN: 2211-5056
2211-5072
DOI: 10.4103/tjo.tjo_40_17
Popis: Visual loss in systemic lupus erythematosus (SLE) due to autoimmune retinopathy (AIR) is rare and easily misdiagnosed as hydroxychloroquine retinopathy. We report the rare clinical presentation of severe visual loss in a patient with SLE due to nonparaneoplastic AIR as differentiated from hydroxychloroquine toxicity. A 70-year-old female diagnosed and treated for lupus for 17 years and had been taking hydroxychloroquine for 15 years. Over the past 2 years, she developed progressive peripheral visual loss oculus uterque which rapidly advanced in the latter 6 months. Hydroxychloroquine toxicity was initially suspected, but diagnostic testing revealed a retinal degeneration. Antiretinal autoantibody testing using Western blot analysis revealed autoantibodies against 44-kDa, 46-kDa (anti-enolase), and 68-kDa proteins. Visual acuity improved in the first 6 months of treatment with mycophenolate mofetil. Our case suggests that AIR should be considered in the differential diagnosis of rapid, severe visual loss in patients with hydroxychloroquine treatment.
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