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葡萄膜炎性青光眼与汉森病:一例报告

Uveitic Glaucoma and Hansen's disease, A case report.

作者信息

Roldan-Vasquez Ana, Roldan-Vasquez Estefania, Vasquez Ana M

机构信息

Massachusetts Eye and Ear, Boston, USA.

Instituto de Oftalmología y Glaucoma Vásquez, Hospital Metropolitano, Quito, Ecuador.

出版信息

Am J Ophthalmol Case Rep. 2021 Apr 22;22:101096. doi: 10.1016/j.ajoc.2021.101096. eCollection 2021 Jun.

Abstract

BACKGROUND

The number of Hansen's disease cases in Latin America and the Caribbean has decreased in the last decade; nevertheless, the region is still struggling with infections caused by This is a case report that portrays the diagnostic and management challenges associated with atypical uveitic glaucoma that is due to Hansen's disease.

CASE PRESENTATION

A 62-year-old female was referred with a 2-year history of anterior uveitis of unknown etiology and ocular hypertension. Past medical history and general physical examination were unremarkable. Upon ocular examination, her best-corrected visual acuity (BCVA) was 20/25 in the OD and 20/60 in the OS. Tonometry showed intraocular pressures (IOPs) of 29 mmHg and 22 mmHg in her right and left eyes, respectively. The slit-lamp examination showed clinical signs of bilateral granulomatous anterior uveitis and cataracts; gonioscopy revealed open angles with some peripheral anterior synechiae for both eyes. Fundus examination and glaucoma tests revealed mild glaucomatous damage in the right eye. Given the presentation of uveitis, the respective questionnaire was completed by internal medicine and rheumatology. Four months later, after bilateral cataract surgery, the patient developed skin plaques on the face, neck, upper back, and extremities, which were biopsied and identified as positive for tuberculoid leprosy.

CONCLUSION

This is the first case report in Ecuador of atypical glaucoma triggered by infectious uveitis produced by . We describe a female patient's clinical presentation with several ocular signs of leprosy and other nonspecific and rarely seen symptoms. Uveitis is a condition that often requires a multidisciplinary team of ophthalmologists and clinicians because of the possible manifestation of an underlying systemic disease, creating a challenge for all the medical personnel involved in the management of the case.

摘要

背景

在过去十年中,拉丁美洲和加勒比地区的麻风病病例数量有所下降;然而,该地区仍在与由[此处原文缺失病原体名称]引起的感染作斗争。这是一份病例报告,描述了与因麻风病导致的非典型葡萄膜炎性青光眼相关的诊断和管理挑战。

病例介绍

一名62岁女性因病因不明的前葡萄膜炎和高眼压病史2年前来就诊。既往病史和全身体格检查均无异常。眼部检查时,她右眼的最佳矫正视力(BCVA)为20/25,左眼为20/60。眼压测量显示右眼和左眼的眼压分别为29 mmHg和22 mmHg。裂隙灯检查显示双侧肉芽肿性前葡萄膜炎和白内障的临床体征;前房角镜检查显示双眼房角开放,有一些周边前粘连。眼底检查和青光眼测试显示右眼有轻度青光眼损害。鉴于葡萄膜炎的表现,内科和风湿病科完成了相应问卷。四个月后,双侧白内障手术后,患者面部、颈部、上背部和四肢出现皮肤斑块,经活检确诊为结核样麻风病阳性。

结论

这是厄瓜多尔首例由[此处原文缺失病原体名称]引起的感染性葡萄膜炎引发的非典型青光眼病例报告。我们描述了一名女性患者的临床表现,伴有多种麻风病眼部体征以及其他非特异性和罕见症状。由于葡萄膜炎可能是潜在全身性疾病的表现,通常需要眼科医生和临床医生组成的多学科团队来处理,这给参与该病例管理的所有医务人员带来了挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd70/8113719/f6ed067a54ff/gr1.jpg

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