Neuroscience (NEUROS) Research Group, NeuroVitae Center for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
Ocul Immunol Inflamm. 2024 Jul;32(5):758-762. doi: 10.1080/09273948.2023.2179498. Epub 2023 Feb 23.
To present a novel association of multiple autoimmune syndrome (MAS) in a patient with sclerouveitis and alkaptonuria.
A 68-year-old female with alkaptonuria, Hashimoto's thyroiditis, and familial autoimmunity presented with decreased VA, red eye, foreign body sensation, and ocular pain. Ophthalmological examination: OD conjunctival hyperemia, ochronosis, a reddish-violet scleral nodule, keratic precipitates, 2+ cells in the anterior chamber, 0.5+ vitreous cells, and mild vitreous haze. The patient was diagnosed with anterior uveitis and anterior nodular scleritis. Due to the associated sicca symptoms, a salivary gland biopsy was ordered, confirming Sjögren's syndrome. Then, MAS was diagnosed, and immunomodulatory medications were started; however, as she was refractory to more than two of them, it was suggested to start biological treatment.
We present a novel MAS-type 2 pattern consisting of Hashimoto's thyroiditis, sclerouveitis, and Sjögren's syndrome. Its diagnosis and management represent a challenge, so a multidisciplinary approach should be provided.
报告 1 例多发性自身免疫综合征（MAS）伴后巩膜炎和黑尿酸尿症的新关联。
1 例 68 岁女性，患有黑尿酸尿症、桥本甲状腺炎和家族性自身免疫性疾病，出现视力下降、眼红、异物感和眼部疼痛。眼科检查：右眼结膜充血，褐黄病，紫红色巩膜结节，角膜后沉淀物，前房 2+细胞，玻璃体 0.5+细胞，轻度玻璃体混浊。患者被诊断为前葡萄膜炎和前结节性巩膜炎。由于存在相关的干燥症状，进行了唾液腺活检，证实为干燥综合征。然后，诊断为 MAS，并开始使用免疫调节药物；然而，由于她对两种以上药物均无反应，建议开始使用生物治疗。
我们报告了一种新型的 MAS 型 2 模式，包括桥本甲状腺炎、后巩膜炎和干燥综合征。其诊断和管理具有挑战性，因此应提供多学科方法。
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