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与菊池-藤本病相关的双侧视网膜前出血。

Bilateral preretinal hemorrhage associated with Kikuchi-Fujimoto disease.

作者信息

Akhavanrezayat Amir, Cooper Joseph D, Hassan Muhammad, Pham Brandon H, Nguyen Quan Dong, Farr Arman K

机构信息

Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.

Division of AIDS Medicine & Infectious Diseases, Department of Medicine, Santa Clara Valley Health & Hospital System, San Jose, CA, USA.

出版信息

Am J Ophthalmol Case Rep. 2021 Mar 2;22:101041. doi: 10.1016/j.ajoc.2021.101041. eCollection 2021 Jun.

Abstract

PURPOSE

To present a case of a patient with human immunodeficiency virus (HIV) disease and Kikuchi-Fujimoto disease (KFD) who presented with a unique pattern of retinopathy.

OBSERVATIONS

A 7-year-old Taiwanese girl with HIV disease who was recently diagnosed with KFD had a sudden onset of blurry vision in both eyes one month after her KFD systemic symptoms had relatively resolved. Ophthalmic examination showed decreased visual acuity in both eyes (OU). On fundus examination, she had bilateral preretinal, subhyaloid, and vitreous hemorrhage that was more severe than anemic retinopathy.

CONCLUSION

Ocular manifestations in Kikuchi-Fujimoto disease are rare; however, if they occur, presentations may vary. The exact etiology of the disease has remained elusive and controversial. This case is the first report of a patient with HIV disease and KFD presenting with ocular involvement. Furthermore, bilateral preretinal, subhyaloid, and vitreous hemorrhage, which was beyond anemic retinopathy, is an unprecedented manifestation of KFD that has not been previously reported. This case highlights the necessity for clinicians to consider all possible differential diagnoses when evaluating patients with similar findings to identify the best therapeutic approach and avoid unnecessary treatment.

摘要

目的

报告一例患有人类免疫缺陷病毒(HIV)疾病和菊池-藤本病(KFD)的患者,其出现了独特的视网膜病变模式。

观察结果

一名7岁患HIV疾病的台湾女孩近期被诊断为KFD,在其KFD全身症状相对缓解一个月后,突然双眼视力模糊。眼科检查显示双眼视力下降。眼底检查发现,她双眼视网膜前、玻璃体下和玻璃体积血,比贫血性视网膜病变更为严重。

结论

菊池-藤本病的眼部表现罕见;然而,如果出现,表现可能各不相同。该疾病的确切病因仍不明确且存在争议。此病例是首例报告的HIV疾病合并KFD且有眼部受累的患者。此外,超出贫血性视网膜病变范围的双眼视网膜前、玻璃体下和玻璃体积血是KFD前所未有的表现,此前未曾报道过。该病例强调了临床医生在评估有类似表现的患者时,考虑所有可能的鉴别诊断以确定最佳治疗方法并避免不必要治疗的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfc2/7940994/962ba284a6ba/gr1.jpg

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