Schüler A, Coupland S E, Krause L, Bornfeld N
Universitäts Augenklinik, Gesamthochschule Duisburg-Essen, Essen.
Klin Monbl Augenheilkd. 2007 Jun;224(6):477-82. doi: 10.1055/s-2007-963274.
Diseases that can clinically simulate an uveitis are summarised under the name Masquerade syndromes. They constitute a heterogenous group of malignant and non-malignant entities that must be excluded in the differential diagnosis. Of the malignant diseases lymphomas are only rarely observed as the cause of a pseudo-uveitis, whereas especially leukaemic diseases and, in childhood, retinoblastomas and the extremely rare intraocular medulloepithelioma must be excluded. Of the non-malignant diseases in childhood, besides Coats' disease, a juvenile xanthogranuloma as well as persisting hyperplastic primary vitreous body should also be considered as the cause of an atypical uveitis. Systemic diseases such as tuberous sclerosis or neurofibromatosis are usually diagnosed in good time by means of the accompanying symptoms. In case of doubt in childhood, an examination under anaesthesia and, if necessary, further imaging diagnostics should be performed in order to avoid with certainty a false diagnosis having possibly serious consequences.
临床上可模拟葡萄膜炎的疾病统称为伪装综合征。它们构成了一组异质性的恶性和非恶性疾病实体,在鉴别诊断中必须排除。在恶性疾病中,淋巴瘤作为假葡萄膜炎的病因很少见,而尤其必须排除白血病性疾病,在儿童中,还须排除视网膜母细胞瘤和极其罕见的眼内髓上皮瘤。在儿童非恶性疾病中,除了科茨病外,青少年黄色肉芽肿以及持续性增生性原发性玻璃体也应被视为非典型葡萄膜炎的病因。结节性硬化症或神经纤维瘤病等全身性疾病通常可通过伴随症状及时诊断。在儿童期如有疑问,应在麻醉下进行检查,必要时进行进一步的影像学诊断,以确保避免可能产生严重后果的误诊。