Yachoui Ralph
Division of Rheumatology, Department of Medicine, Marshfield Clinic, Marshfield, Wisconsin.
Retin Cases Brief Rep. 2018;12(4):379-381. doi: 10.1097/ICB.0000000000000515.
To describe clinical, laboratory, and funduscopic data of a patient presenting with newly diagnosed adult-onset Still disease and Purtscher-like retinopathy.
Observational case report.
A 43-year-old man presented with a 3-week history of daily high-spiking fever, diffuse arthralgia and myalgia, sore throat, and a transient nonpruritic maculopapular rash. Two weeks from the onset of his illness, he developed a gradual decrease in visual acuity in both eyes. Fundoscopic examination showed multiple areas of retinal whitening, discrete superficial retinal hemorrhages, and few characteristic Purtscher flecken in the left eye.
The patient was diagnosed with adult-onset Still disease. We used high-dose corticosteroid therapy with complete resolution of adult-onset Still disease, but it was ineffective for recovery of vision.
Clinicians should be aware of Purtscher-like retinopathy as a severe ophthalmic complication of adult-onset Still disease.
描述一名新诊断为成人斯蒂尔病并伴有类普尔夏视网膜病变患者的临床、实验室及眼底检查数据。
观察性病例报告。
一名43岁男性,有3周每日高热、弥漫性关节痛和肌痛、咽痛及一过性非瘙痒性斑丘疹病史。发病两周后,他双眼视力逐渐下降。眼底检查显示左眼有多个视网膜变白区域、散在的浅层视网膜出血及少量典型的普尔夏斑。
该患者被诊断为成人斯蒂尔病。我们采用大剂量皮质类固醇治疗,成人斯蒂尔病完全缓解,但视力恢复无效。
临床医生应意识到类普尔夏视网膜病变是成人斯蒂尔病的一种严重眼部并发症。