Purpose: To report the case of a patient with multiple food allergies comorbid with multiple chemical sensitivity (MCS) who was misdiagnosed on various occasions, resulting in a negative impact on the patient's personal and social life. Case Report: We present the case of a 43-year-old Colombian women with multiple food allergies concomitant with MCS. Symptoms started with a mild reaction to insecticides, car exhaust smoke, and perfumes and gradually evolved into a severe reaction to her environment. She also presented recurrent episodes of clinical reactivity to foods and persistent elevated IgE levels, as well as several life-threatening anaphylactic reactions. Alternative and allopathic therapies were applied, but her symptoms persisted. Various diagnoses were made before the definitive diagnosis. Conclusion: MCS is an unusual entity of unknown pathophysiology that can, on rare occasions, coexist with food allergies. Early recognition and multidisciplinary treatment are required as these entities have a major impact on the patient's quality of life. We present the first Latin American case regarding the association of the two diseases.
This scoping review examined the relationship between Dry Eye Disease (DED) and Uveitis. We searched Pubmed, Embase, and LILACS databases for articles in which at least one patient had DED and uveitis concomitantly. The search produced 2381 records, and 24 studies were included in the qualitative synthesis. We concluded that DED and uveitis of any etiology could appear concomitantly in patients of any age. However, both diseases seem to coexist more frequently in middle-aged women and cases of anterior uveitis. Therefore, it is crucial that ophthalmologists actively look for the coexistence of ocular surface abnormalities, especially in patients with these characteristics. Future studies should establish and quantify the risk factors and pathophysiological mechanisms of this coexistence to achieve an early diagnosis of both etiologies and comprehensive management of these patients.
Purpose To analyze the etiology, clinical characteristics, complications, treatments, and outcomes of patients with intermediate uveitis examined in a uveitis referral center in Bogotá, Colombia. Patients and Methods We conducted a retrospective descriptive study. We reviewed systematically the clinical records of patients attending a uveitis referral center in Bogotá, Colombia from 2013 to 2020. Data analysis included demographics, etiology, clinical characteristics, treatment modalities, best-corrected visual acuity, and complications. For categorical variables, absolute and relative frequencies were used while for continuous variables mean and standard deviations were calculated. Results We identified 18 patients with intermediate uveitis. The mean age at disease onset was 19.4 years. There was no sex predominance. Two-thirds of the patients presented bilateral involvement. The mean initial best-corrected visual acuity was 0.19 LogMAR. The most common etiology was idiopathic followed by undetermined, tuberculosis, multiple sclerosis, and juvenile idiopathic arthritis. The most common characteristics were insidious onset, chronic course, and persistent duration. The complications found were macular edema, optic disk edema, cataract, epiretinal membrane, among others. Corticosteroids and immunosuppressive therapy were the most common treatments. Mean follow-up time was 24.4 months, and the mean final best-corrected visual acuity was 0.12 LogMAR. Conclusion This is the first study describing intermediate uveitis features in South America. In our context, intermediate uveitis is infrequent. Polyautoimmunity and familial autoimmunity phenomena were found in some patients. These may require a multidisciplinary approach. Ophthalmologists should promptly diagnose, treat, and refer patients with this disease to avoid common complications. Further studies are required to determine the disease relation with polyautoimmunity.
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