Serum and Cerebrospinal Fluid Testing in Optic Neuropathy Patients with Malignant Tumors

Sun, Chuan-bin; Liu, Geng-hao; Xiao, Qing; Zhao, Yi-nv; Ren, Qi

doi:10.1155/2022/7076385

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…Ocular involvement in scrub typhus cases mostly occurred at its post-fever or recovery stage, and was predominantly manifested as mild conjunctivitis, uveitis, retinitis or retinal vasculitis (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). However, ON was not uncommon in scrub typhus cases (6, 9, 18-20).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, TBA revealed an intracellular antineuronal autoantibody in the serum of the patient, but no responsible autoantibodies such as antinuclear antibodies were detected in this study. Hence, more investigations including paraneoplastic syndrome and autoimmune encephalitis autoantibody test need to be done to exclude whether there exists a currently unknown antineuronal autoantibody in this case (14,27,29).…”

Section: Discussionmentioning

confidence: 99%

“…Cell-based indirect immunofluorescence assay (CBA) using HEK-293 cells as substrate was performed to detect serum aquaporin 4-IgG antibody (AQP-4 Ab), myelin oligodendrocyte glycoprotein-IgG antibody (MOG-Ab), and glial fibrillary acidic protein-IgG antibody (GFAP-Ab). Tissue-based indirect immunofluorescence assay (TBA) using monkey cerebellum tissue sections as substrate was also performed to detect possible serum antineuronal and antiglial cell autoantibodies following procedures reported in previous literature ( 13 , 14 ). This study was conducted according to the tenets of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

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Case Report: Optic neuritis as the initial presentation of Orientia tsutsugamushi infection detected by metagenomic next-generation sequencing

Sun

Liu

2023

Front. Immunol.

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Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi infection, and typically manifested as fever, eschar, lymphadenopathy, rash, and other flu-like signs. Ocular involvement was not uncommon, and mostly occurred at post-fever or recovery stage in scrub typhus cases. We hereby report a case of scrub typhus presenting as unilateral optic neuritis (ON). A 56-year-old man going wild fishing nearly every day complained of a blurred vision and an inferior visual field defect in the right eye two or three days after an insect-bite like shin induration in his left leg. He was diagnosed as ON, and treated with dexamethasone in the local hospital. Unfortunately, his right eye vision progressively deteriorated during steroid therapy. Three days after steroid therapy ceased, he suffered from a high fever and painful subcutaneous masses in the left groin. Peripheral blood test by metagenomic next-generation sequencing (mNGS) was positive for Orientia tsutsugamushi, but negative for other pathogens. The diagnosis was then revised to scrub typhus and ON. His systemic symptoms rapidly disappeared after oral doxycycline and omadacycline therapy. However, his right eye vision continuously deteriorated to hand motion. Further serum tests for aquaporin 4-IgG antibody and myelin oligodendrocyte glycoprotein-IgG antibody were both negative, but for anticardiolipin IgM and beta-2-glycoprotein-I IgM were both positive. The patient’s right eye vision gradually improved after doxycycline combined with steroid pulse therapy. Our case indicates that ON in scrub typhus cases may present as a parainfectious inflammation, and that mNGS is a useful and valuable method for early diagnosis of scrub typhus.

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