与类Purtscher视网膜病变相关的冷球蛋白血症
Cryoglobulinemia associated with Purtscher-like retinopathy.
作者信息
Myers J P, Di Bisceglie A M, Mann E S
机构信息
Department of Ophthalmology, Saint Louis University Health Sciences Center, St. Louis, Missouri, USA.
出版信息
Am J Ophthalmol. 2001 Jun;131(6):802-4. doi: 10.1016/s0002-9394(00)00905-3.
PURPOSE
To report a case of Purtscher-like retinopathy in a young man with chronic hepatitis C--associated cryoglobulinemia.
METHODS
Case report.
RESULTS
A 44-year-old Caucasian man with chronic hepatitis C developed sudden loss of vision in the left eye and abdominal pain. Ocular fundus examination revealed peripapillary cotton-wool spots and superficial retinal whitening in the macula. Systemic evaluation revealed markedly elevated rheumatoid factor, hypertension, and acute renal insufficiency. A renal biopsy demonstrated intravascular deposition of immunoglobulins IgG and IgM and complement consistent with type II mixed cryoglobulinemia.
CONCLUSION
Clinicians should consider cryoglobulinemia in the differential diagnosis of a patient with Purtscher-like retinopathy and history of infection with hepatitis C.
目的
报告1例患有慢性丙型肝炎相关冷球蛋白血症的年轻男性发生的类Purtscher视网膜病变。
方法
病例报告。
结果
1名44岁患有慢性丙型肝炎的白种男性突然出现左眼视力丧失和腹痛。眼底检查发现视乳头周围棉絮斑和黄斑区视网膜浅层变白。全身评估显示类风湿因子显著升高、高血压和急性肾功能不全。肾活检显示血管内免疫球蛋白IgG和IgM以及补体沉积，符合II型混合性冷球蛋白血症。
结论
临床医生在对患有类Purtscher视网膜病变且有丙型肝炎感染史的患者进行鉴别诊断时应考虑冷球蛋白血症。
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