Basso A, Mansouri K, Frueh B E, Guex-Crosier Y
Jules-Gonin Eye Hospital, University of Lausanne, Lausanne, Switzerland.
Klin Monbl Augenheilkd. 2010 Apr;227(4):306-8. doi: 10.1055/s-0029-1245202. Epub 2010 Apr 20.
The association of a granulomatous uveitis and congenital cataract and is rarely observed in newborn children. We describe the history of two patients presenting simultaneously with these two features in the absence of a TORCH infection.
The first patient, a boy born in 1997, presented to our hospital two days after birth with multiples Koeppe's and Busacca's nodules and bilateral cataract. The second patient, a boy born in 2006, was referred two weeks after birth. He presented with a severe unilateral granulomatous uveitis, multiples iris nodules, a high intraocular pressure of 45 mmHg and a congenital cataract.
Lens extraction produced a rapid resolution of uveitis in these two patients. TORCH infection was ruled out in both children by history, extensive serologies performed simultaneously in mother and child or PCR of ocular fluids.
A congenital cataract associated with a granulomatous uveitis is an extremely rare association. The removal of the lens resulted in complete resolution of the inflammation: a phacogenic mechanism could be at the origin of ocular inflammation in both cases.
肉芽肿性葡萄膜炎与先天性白内障的关联在新生儿中很少见。我们描述了两名同时出现这两种特征且无TORCH感染的患者的病史。
首例患者为一名1997年出生的男孩,出生两天后因多发性科佩氏结节和布萨卡氏结节以及双侧白内障前来我院就诊。第二例患者为一名2006年出生的男孩,出生两周后前来就诊。他患有严重的单侧肉芽肿性葡萄膜炎、多发性虹膜结节、眼压高达45 mmHg以及先天性白内障。
晶状体摘除术使这两名患者的葡萄膜炎迅速消退。通过病史、同时对母婴进行的广泛血清学检查或眼液PCR检测,排除了两名儿童的TORCH感染。
先天性白内障合并肉芽肿性葡萄膜炎是一种极其罕见的关联。晶状体摘除导致炎症完全消退:在这两例病例中,致晶状体性机制可能是眼部炎症的根源。