Purpose: To report rare but important instances of very severe, hyperacute HLA B27-associated panuveitis, mimicking infective endophthalmitis and providing challenges to both diagnosis and management.
Design: Retrospective case review.
Methods: Four patient records were reviewed. Demographic features, clinical findings, course of uveitis, diagnostic/therapeutic measures, and outcomes are reported.
Results: All cases presented with severe panuveitis with visual acuities below 6/60 and poor fundal views. Three patients underwent intraocular fluid sampling for microbiology. All required systemic high-dose corticosteroid treatment, and two also needed oral immunosuppression. All eventually required cataract extraction. Final visual acuity varied from 6/12 to 6/6.
Conclusions: HLA B27-associated uveitis may be unusually severe and may cause a panuveitis, mimicking infective endophthalmitis. The course may be prolonged and difficult with frequent complications including cataract.
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http://dx.doi.org/10.3109/09273940903560236 | DOI Listing |
Retinopathy, small fiber neuropathy (SFN), and encephalopathy associated with recoverin antibodies have not been previously reported as side effects of BNT162b2 vaccination in a patient with HLA-B27-associated spondylarthritis. The patient is a 47-year-old male with a 10-year history of HLA-B27-associated spondylarthritis without recurrence, who developed acute and post-acute COVID vaccination syndrome (ACVS/PACVS) after the first dose of the BNT162b2 vaccine. The PACVS manifested as cerebral disease, eye disease, and SFN.
View Article and Find Full Text PDFIndian J Ophthalmol
September 2024
Department of Rheumatology, Manipal Hospitals, Millers Road, Bengaluru, Karnataka, India.
Br J Ophthalmol
August 2024
Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA
Background/aims: To explore and characterise the clinical phenotype of acute anterior uveitis flares with delayed severity in patients with human leucocyte antigen B27 (HLA-B27)-associated anterior uveitis.
Methods: Retrospective chart review of patients with HLA-B27-associated anterior uveitis. Demographic and clinical data were recorded, as well as the clinical characteristics of acute anterior uveitis flares.
Best Pract Res Clin Rheumatol
May 2024
New York University Grossman School of Medicine, Department of Medicine, New York, NY, USA; New York University Grossman School of Medicine, Department of Pathology, USA; New York University Grossman School of Medicine, Department of Medicine Division of Rheumatology, NYU Langone Ocular Rheumatology Program, New York, NY, USA; New York University Grossman School of Medicine, Department of Medicine, Division of Rheumatology, NYU Langone Center for Behçet's Disease, New York, NY, USA. Electronic address:
Human leukocyte antigen (HLA) class I association is a well-established feature of common and uncommon inflammatory diseases, but it is unknown whether it impacts the pathogenesis of these disorders. The "arthritogenic peptide" hypothesis proposed initially for HLA-B27-associated ankylosing spondylitis (AS) seems the most intuitive to serve as a model for other HLA class I-associated diseases, but evidence supporting it has been scarce. Recent technological advances and the discovery of epistatic relationships between disease-associated HLA class I and endoplasmic reticulum aminopeptidase (ERAP) coding variants have led to the generation of new data and conceptual approaches to the problem requiring its re-examination.
View Article and Find Full Text PDFJCI Insight
July 2024
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
HLA-B*27 was one of the first HLA alleles associated with an autoimmune disease, i.e., axial spondyloarthritis (axSpA) and acute anterior uveitis (B27AAU), which cause joint and eye inflammation, respectively.
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