Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Wegener's granulomatosis (WG) is characterized by granulomatous vasculitis of the upper and lower respiratory tract together with glomerulonephritis. The majority of cases have ocular, sinus and ear symptomatology. A case is presented with severe granulomatous disease of the sinuses with contiguous spread to the orbit producing exophthalmos and decreased vision. An orbital decompression relieved the pressure and preserved vision. The definitive medical therapy for WG is cyclophosphamide. Emergency orbital decompression may be necessary to preserve vision in WG in patients with rapidly decreasing vision secondary to high intraocular pressure produced by the granulomatous process.
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PMID:Wegener's granulomatosis: unusual indication for orbital decompression. 42 47

A case of retinal vasculitis is reported, unusual because of its occurrence in a young healthy man, and especially because of the presence of a turn-over of white spots in the mid-peripheral retina, which faded and turned into areas of pigment epithelium changes. The patient presented with anterior uveitis with raised intraocular pressure, and then with vitritis, retinitis in the peripapillary area with involvement of the optic disc, vasculitis with perivascular sheathing and vascular occlusion. Clinical and laboratory investigations remained negative. The lesions regressed with antiviral treatment (Ganciclovir) and steroids. Final visual acuity was 20/400 due to optic disc atrophy and the development of an epimacular membrane. The authors discuss the differential diagnosis of retinal vasculitis related to immunological diseases or viral infection. In conclusion, this case may constitute a mild type of acute retinal necrosis syndrome.
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PMID:[Viral vasculitis and disseminated white spots]. 808 11

We compared 23 patients (ages 4 to 18 years) who were receiving long-term oral prednisone therapy with 31 normal controls (ages 7 to 16 years). Indications for corticosteroid treatment included renal transplant in 11 patients, nephrotic syndrome in 7, glomerulonephritis in 4, and vasculitis without renal disease in 1. The mean duration of prednisone therapy was 5.0 +/- 3.5 years, and the mean dose at the time of examination was 0.29 +/- 0.18 mg/kg/day. Mean intraocular pressure was 16.0 +/- 3.0 mm Hg (range, 12 to 25 mm Hg) in the prednisone group and 15.4 +/- 2.1 mm Hg (range, 12 to 20 mm Hg) in the control group. The difference between the means was 0.6 mm Hg (P = 0.35). Posterior subcapsular cataracts were present in seven (30%) of the prednisone patients, but in none of the controls (P = .001). None of the cataracts were visually significant. We found no evidence that pediatric patients on long-term, low-dose prednisone have higher intraocular pressures (IOPs) than normal children, although they are more likely to develop posterior subcapsular cataracts.
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PMID:Ocular implications of long-term prednisone therapy in children. 835 Feb 20

An occlusion of the central retinal artery (CRAO) leads to a unilateral acute painless loss of vision. The individual etiology remains unclear in many cases. Potential pathomechanisms are embolism, vasoobliteration and vascular compression. Emboli (calcified, thrombotic, myxomatous, bacterial or cholesterol) are of carotid or cardiac origin. Atherosclerotic plaques, giant-cell arteritis and other types of vasculitis may cause vasoobliteration. A retrobulbar mass (hematoma, neoplasms, retrobulbar injections) may lead to an optic nerve and central retinal artery compression. Funduscopic signs of CRAO are described. Late development of iris neovascularization and neovascular secondary glaucoma may occur in up to 15 percent of cases. The prognosis of CRAO has been poor. A spontaneous remission and recovery of visual function is rare. It has been shown experimentally that the retinal damage is irreversible after 100 minutes of non-perfusion. The initial treatment should include an immediate paracentesis of the anterior chamber, digital massage of the globe, and i.v. administration of 500 mg azetazolamide in order to stimulate retinal reperfusion by lowering the intraocular pressure. This procedure is recommended for the first 6 (up to 24) hours after onset of CRAO. More promising success rates have recently be reported by a selective intra-arterial fibrinolysis with Urokinase (100,000-1,000,000 IU) or recombinant plasminogen activator (rtPA). In a personal series of 18 cases, intra-arterial fibrinolysis with Urokinase was performed. A final visual acuity of 6/10 to 6/6 was achieved in 30 percent of the cases.
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PMID:[Central retinal artery occlusion--etiology, clinical picture, therapeutic possibilities]. 1121 85

A 63-year-old man with HZO presented with involvement of cranial nerves II, III, IV, V, and VI, with proptosis, raised intraocular pressure, and chemosis. With the aid of orbital imaging, a diagnosis of orbital apex inflammation secondary to HZO was confirmed, and he was treated with intravenous acyclovir and oral steroids. Despite this, he made a minimal recovery at eight months following presentation. Severe, irreversible orbital disease may develop following HZO, and an ischemic vasculitis may play a role in the pathogenesis of the disease.
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PMID:Severe, permanent orbital disease in herpes zoster ophthalmicus. 1871 75

A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. He started treatment with azithromycin, pyrimethamine, topical steroids and measures for control of intraocular pressure. Serology for Toxoplasma gondii was positive and for HIV, negative. For headache and vomiting, he was hospitalised in order to exclude cerebral toxoplasma. The cerebral CT scan, MRI and lumbar puncture were negative and treatment was changed to pyrimethamine, sulfadiazine and prednisolone. For persistence of vomiting he started clindamycin with clinical and ophthalmological improvement. The patient is currently under prophylaxis with co-trimoxazol for 1 year, and maintains clinical improvement. This case illustrates the rarity of presentation of ocular toxoplasmosis, without cerebral in an immunocompetent patient.
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PMID:Ocular toxoplasmosis: a very rare presentation in an immunocompetent patient. 2527 Jan 56

Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis.
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PMID:Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis. 2757 46

Purpose: To report a case of postoperative cataract bacterial endophthalmitis masquerading as hemorrhagic occlusive retinal vasculitis (HORV). Case Report: A 69-year-old female presents following uncomplicated cataract surgery of her right eye with new onset floaters, aching pain, decreased visual acuity, increased intraocular pressure, deep anterior chamber reaction, vitritis, and retinal vascular sheathing with diffuse blot hemorrhages. The majority of these clinical symptoms are commonly seen in bacterial endophthalmitis with exception to the retinal findings, which point to possible diagnosis of HORV, a recently described, largely untreatable phenomena associated with intracameral vancomycin use during surgery. After careful investigation and examination, our patient was successfully treated with pars plana vitrectomy and intravitreal antibiotics. Conclusion: This case report describes the unusual case of a postoperative bacterial endophthalmitis presenting with characteristic signs of HORV, a largely untreatable, exceedingly rare phenomena that commonly results in poor visual acuity.
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PMID:Postoperative Cataract Endophthalmitis Masquerading as Hemorrhagic Occlusive Retinal Vasculitis (HORV): A Case Report. 3141 16