Patel Arti A, Stutman Amelia, Patel Prarak, Capoccia Madhavi
Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA, USA.
College of Osteopathic Medicine, Kansas City University of Medicine and Biosciences, Kansas City, MO, USA.
SAGE Open Med Case Rep. 2020 Dec 14;8:2050313X20981460. doi: 10.1177/2050313X20981460. eCollection 2020.
Behcet's disease is a chronic, idiopathic vasculitis with multisystem involvement commonly characterized by the classic triad of oral lesions, genital ulcerations, and uveitis. We discuss the case of a 22-year-old woman with a long-standing history of oral ulcers and vulvovaginal burning who presented with acute painless uveitis. With this presentation, there was an initial concern for infectious retinitis for which she was started on systemic antiviral therapy. Subsequent infectious disease workup was ultimately negative. Given her medical history and current presentation, she was diagnosed and treated for an acute inflammatory episode of ocular Behcet's disease. The patient's vision returned to baseline prior to discharge after treatment with systemic glucocorticoids. The diagnosis of Behcet's disease in the setting of painless vision loss can oftentimes be elusive. However, it is important for clinicians to keep this condition as a differential diagnosis in patients presenting with acute onset uveitis as the progression of Behcet's disease can lead to severe vision loss and blindness without prompt and adequate treatment.
白塞病是一种慢性特发性血管炎，累及多系统，通常以口腔溃疡、生殖器溃疡和葡萄膜炎这一经典三联征为特征。我们讨论一例22岁女性病例，该患者有长期口腔溃疡和外阴阴道灼痛病史，此次因急性无痛性葡萄膜炎就诊。鉴于此表现，最初怀疑为感染性视网膜炎，遂开始给予全身抗病毒治疗。随后的传染病检查最终结果为阴性。鉴于其病史和当前表现，她被诊断为眼部白塞病急性炎症发作并接受治疗。经全身糖皮质激素治疗后，患者视力在出院前恢复至基线水平。在无痛性视力丧失情况下，白塞病的诊断往往难以捉摸。然而，对于临床医生而言，在急性葡萄膜炎患者中，将此病作为鉴别诊断很重要，因为白塞病若不及时、充分治疗，病情进展可导致严重视力丧失甚至失明。
