The ocular manifestations of Wegener's granulomatosis

Haynes, Barton F.; Fishman, Martin L.; Fauci, Anthony S.; Wolff, Sheldon M.

doi:10.1016/0002-9343(77)90125-5

Cited by 274 publications

(24 citation statements)

References 64 publications

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“…Ophthalmologic involvement is one of the main complications of GCA and may lead to blindness. However, most of the SNV may localize to the orbit (43)(44)(45). The overlap between the ocular manifestations of GCA and those of other vasculitides may be confusing and lead to a misdiagnosis, particularly when the latter are localized to the temporal artery, as in our patients, or revealed by neuroophthalmologic symptoms (46,47).…”

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confidence: 87%

Temporal artery biopsy: A diagnostic tool for systemic necrotizing vasculitis

G�n�reau¹,

Lortholary²,

Pottier³

et al. 1999

Arthritis & Rheumatism

128

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Objective. To describe the clinical, biologic, and histologic features of temporal artery biopsy (TAB)-localized systemic necrotizing vasculitides (SNV), and to assess their frequency among elderly patients undergoing TAB for suspected giant cell (temporal) arteritis (GCA).Methods. The frequency of a TAB localization of SNV was prospectively assessed in a multicenter study of elderly patients undergoing TAB for suspected GCA. All patients with SNV fulfilling the American College of Rheumatology criteria for a specific vasculitic syndrome and with evidence of vasculitis on TAB were included in a retrospective, descriptive study.Results. SNV was diagnosed based on the TAB in 1.4% of the patients with suspected GCA and in 4.5% of the positive (inflamed) TAB specimens. We retrospectively selected 27 patients (18 female, 9 male; mean ؎ SD age 62 ؎ 15 years, range 22-79 years) with SNV and TAB-localized vasculitis. Only 2 of these patients were known to have SNV before TAB localization. Twenty-two patients (81%) had cephalic symptoms, including jaw claudication in 33%, clinically abnormal temporal arteries in 33%, and neuro-ophthalmologic symptoms in 11%. All patients had systemic symptoms suggestive of SNV and histologically proven NV in the TAB specimens (70%) or elsewhere in other biopsy sites (74%). Abnormal biologic results suggestive of SNV were present in 17 patients (63%). For 4 patients, the TAB-documented involvement led to initial misdiagnoses of GCA, and systemic manifestations that developed under steroid therapy revealed the correct diagnosis. The final diagnoses of the patients were polyarteritis nodosa (PAN) (n ‫؍‬ 11), Churg-Strauss syndrome (n ‫؍‬ 6), micropolyangiitis (n ‫؍‬ 3), Wegener's granulomatosis (n ‫؍‬ 3), hepatitis B virus-related PAN (n ‫؍‬ 2), hepatitis C virus-related cryoglobulinemic vasculitis (n ‫؍‬ 1), and rheumatoid vasculitis (n ‫؍‬ 1).Conclusion. TAB-localized SNV presents a major diagnostic dilemma because it can mimic GCA. Careful analysis of clinical, biologic, and histologic data should lead to the correct diagnosis and help guide the clinician's choice of appropriate therapy.

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confidence: 87%

Temporal artery biopsy: A diagnostic tool for systemic necrotizing vasculitis

G�n�reau¹,

Lortholary²,

Pottier³

et al. 1999

Arthritis & Rheumatism

128

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“…Uveitis tends to occur in less than 10% of patients and is thought to be spillover of inflammation from adjacent scleritis or keratitis. 91-94 Occlusion of retinal veins and arteries is uncommon but can occur in GPA and EGPA. 95-98 …”

Section: Male Predominant Uveitides With Systemic Involvementmentioning

confidence: 99%

The Role of Sex in Uveitis and Ocular Inflammation

Yeung¹,

Popp²,

Chan³

2015

International Ophthalmology Clinics

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Uveitides can be due to non-infectious and infectious etiologies. It has been observed that there is a gender difference with a greater preponderance of non-infectious uveitis in women than in men. This review will describe both non-infectious and infectious uveitides and describes some of the current autoimmune mechanisms thought to be underlying the gender difference. It will specifically look at non-infectious uveitides with systemic involvement including juvenile idiopathic arthritis, spondyloarthopathies, sarcoidosis, Behçet’s disease, and Vogt-Koyanagi-Harada disease and at uveitides without systemic involvement including sympathetic ophthalmia, birdshot chorioretinitis, and the white dot syndromes. Infectious uveitides like acute retinal necrosis, progressive outer retinal necrosis, and cytomegalovirus mediated uveitis will be mentioned. Different uveitides with female- or male- predominance are presented and discussed.

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“…Amongst the sites that have a substantial potential for morbidity are the eye and the nervous system. A wide spectrum of ocular manifestations has been observed in WG which may threaten vision by affecting the eye directly or by involvement of its contiguous structures 7. Such manifestations include episcleritis, scleritis, conjunctivitis, keratitis, uveitis, retinal vasculitis, optic neuritis, and retro-orbital pseudotumour.…”

Section: Clinical Featuresmentioning

confidence: 99%