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结核病:葡萄膜炎中一种诊断不足但有有效治疗方法的病因。

Tuberculosis: an under-diagnosed aetiological agent in uveitis with an effective treatment.

作者信息

Varma D, Anand S, Reddy A R, Das A, Watson J P, Currie D C, Sutcliffe I, Backhouse O C

机构信息

Leeds General Infirmary, Leeds, West Yorkshire, UK.

出版信息

Eye (Lond). 2006 Sep;20(9):1068-73. doi: 10.1038/sj.eye.6702093. Epub 2005 Oct 7.

Abstract

PURPOSE

To highlight the diversity of clinical presentations with tubercular uveitis in a nonendemic setting, and discuss the diagnostic approach and an effective treatment.

METHOD

Descriptive case series.

RESULTS

A total of 12 cases of varied presentations of tubercular uveitis diagnosed over a period of 1 year of which six cases are described in detail. Presentations included choroidal tuberculomas, multifocal choroiditis, recurrent granulomatous uveitis, panuveitis with cystoid macular oedema, and serpiginous choroiditis. All cases had a chronic or recurrent course and responded very well to antitubercular treatment. Diagnosis was mainly assisted by positive tuberculin testing.

CONCLUSION

A high index of suspicion helps diagnose ocular tuberculosis in areas of low prevalence of the disease. It forms part of the differential diagnosis of any chronic or recurrent uveitis, especially in an at-risk patient. Antitubercular treatment seems highly effective.

摘要

目的

强调在非流行地区结核性葡萄膜炎临床表现的多样性,并探讨其诊断方法及有效治疗。

方法

描述性病例系列。

结果

在1年时间内共诊断出12例表现各异的结核性葡萄膜炎病例,其中6例详细描述如下。表现包括脉络膜结核瘤、多灶性脉络膜炎、复发性肉芽肿性葡萄膜炎、伴有黄斑囊样水肿的全葡萄膜炎以及匐行性脉络膜炎。所有病例病程呈慢性或复发性,对抗结核治疗反应良好。诊断主要依靠结核菌素试验阳性。

结论

在疾病低流行地区,高度怀疑有助于诊断眼部结核。它是任何慢性或复发性葡萄膜炎鉴别诊断的一部分,尤其是在高危患者中。抗结核治疗似乎非常有效。

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