Purtscher-like retinopathy as presenting manifestation of systemic lupus erythromatosus following high-grade fever with myalgia and arthralgia

Palkar, Amit H; Hossain, M Delwar; Majumder, Parthopratim Dutta

doi:10.4103/ijo.ijo_549_18

Cited by 7 publications

(3 citation statements)

References 3 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All patients with HIV, Tuberculosis and Syphilis were excluded from the study. Individuals with history of fever and retinitis due to Behcet's disease and systemic lupus erythematosus [ 20 ] were also eliminated. PFR individuals who had inflammatory disorders of the eye, uncontrolled glaucoma, hypertension and diabetes were also excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Mycobiome changes in the vitreous of post fever retinitis patients

et al. 2020

View full text Add to dashboard Cite

Fungi have been associated with various diseases of the eye like keratitis, uveitis and endophthalmitis. Despite this fact, fungal microbiome (mycobiome) studies compared to the bacterial microbiome studies have remained neglected. In the present study, using metagenomic sequencing, the mycobiomes of the vitreous of healthy control individuals (VC, n = 15) and individuals with post fever retinitis + non-PFR uveitis (PFR+, n = 9) were analysed and compared. The results indicated that Ascomycota was the most predominant phylum in both VC and PFR+ groups. Further, at the genera level it was observed that the abundance of 17 fungal genera were significantly different in post fever retinitis (PFR, n = 6) group compared to control group. Of these 17 genera, it was observed that 14 genera were relatively more abundant in PFR group and the remaining 3 genera in the VC group. Genus Saccharomyces, a commensal of the gut and skin, was predominantly present in the vitreous of both the cohorts, however it was significantly less abundant in PFR group. Further, significant increase in the genera that have a pathogenic interaction with the host were observed in PFR group. On the whole the mycobiome in both the groups differed significantly and formed two distinct clusters in the heatmap and Principal co-ordinate analysis. These results demonstrate significant changes in the mycobiome from the vitreous of post fever retinitis patients compared to healthy controls thus implying that dysbiotic changes in the fungal vitreous microbiome are associated with PFR.

show abstract

Section: Methodsmentioning

confidence: 99%

Mycobiome changes in the vitreous of post fever retinitis patients

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Another study reported Purtscher-like retinopathy as the initial sign of systemic involvement in a 15-year-old girl, who was successfully treated with oral steroids and hydroxychloroquine. [ 16 ] Similarly, a few other authors also reported ocular involvement as the first sign of SLE. In a prospective study of 43 confirmed SLE patients, seven patients developed retinopathy over a period of 5 years.…”

Section: Discussionmentioning

confidence: 91%

Systemic lupus erythematosus (SLE) associated uveitis in India – A case series

Magesan,

Nangia,

Manoharan

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: To report the uveitic manifestations of patients with systemic lupus erythematosus (SLE). Methods: This was a retrospective analysis of all SLE cases with ocular manifestations seen by a single ophthalmologist between 2015 and December 2021. Results: In total, seven patients with a median age of 40 (range 18–50) years were included in the study. Female (85.7%) predominance was noted. Ocular findings were bilateral in 71% (five patients) of cases. Majority (10 eyes, 83%) of the patients had retinal vasculitis as the common finding. Antinuclear antibodies were positive in all the patients. The vision improved in two (16.6%) eyes, was stable in eight (66%) eyes, and worsened in one (8%) eye. All the patients were treated with oral steroids along with immunosuppressive agents. Conclusion: Though SLE is rare cause of uveitis, it can be associated with significant ocular morbidity. Hence, early diagnosis and treatment can salvage vision in many cases.

show abstract

“…Our patient presented with acute vision change from panuveitis and retinal vasculitis as her only manifestation of the disease, making this case unique. In the literature, this has been reported in a few cases: Purtscher-like retinopathy was described as the presenting symptom of a 15-year-old girl in India who was successfully treated with steroids and hydroxychloroquine [ 9 ]. Other cases of retinal vasculitis include a 13-year-old boy with photosensitive SLE rashes [ 10 ] and a 19-year-old girl with sudden vision loss whose vasculitis was felt to be entirely inflammatory with no vaso-occlusive contribution to the retinopathy [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

et al. 2021

View full text Add to dashboard Cite

Patient: Female, 14-year-old Final Diagnosis: Retinal vasculitis Symptoms: Itchy eyes Medication: — Clinical Procedure: — Specialty: Rheumatology Objective: Unusual clinical course Background: Systemic lupus erythematosus (SLE) can involve any part of the eye. Keratoconjunctivitis sicca (dry eye) is the most common ocular manifestation, followed by scleritis, episcleritis, and retinitis. Retinal disease affects around 10% of patients with SLE. Mild retinopathy may be asymptomatic. However, severe cases can cause visual loss requiring urgent ophthalmic evaluation. Case Report: We present a case of bilateral retinal vasculitis as the presenting manifestation of SLE. A 14-year-old girl with a history of schizophrenia presented to the emergency department (ED) with generalized weakness. Four days before her presentation, she developed itching in her eyes and frontal headaches. In the ED, she reported blurry vision in her left eye only and diffuse arthralgia. The ophthalmic evaluation showed bilateral reduced visual acuity, worse in the left eye. Both eyes had diffuse hemorrhages, white retinal lesions, and blurred optic disc margins. She was diagnosed with panuveitis and retinal vasculitis. The patient was then found to have SLE, diagnosed by the presence of arthralgias, panuveitis, severe bilateral retinal vasculitis, positive ANA and anti-dsDNA, and normocytic anemia. The patient received intravenous methylprednisolone with subsequent oral prednisone upon discharge, hydroxychloroquine, and azathioprine. One year after her presentation, she had significant visual improvement and no other system involvement. Conclusions: Retinal vasculitis, as the presenting symptom of SLE, has been overlooked in large studies. However, the number of case reports documenting this as a presenting symptom, often with minimal or no organ involvement, suggests that upon diagnosis, patients might benefit from a skilled ophthalmic evaluation.

show abstract

Purtscher-like retinopathy as presenting manifestation of systemic lupus erythromatosus following high-grade fever with myalgia and arthralgia

Cited by 7 publications

References 3 publications

Mycobiome changes in the vitreous of post fever retinitis patients

Mycobiome changes in the vitreous of post fever retinitis patients

Systemic lupus erythematosus (SLE) associated uveitis in India – A case series

Bilateral Retinal Vasculitis as the First Presentation of Systemic Lupus Erythematosus

Contact Info

Product

Resources

About