Daniel Lemor1, David B Lazar2, W Brooks Emory3, Jonathan D Nussdorf1. 1. Department of Ophthalmology, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA. 2. Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA. 3. Department of Pulmonology and Critical Care, Ochsner Clinic Foundation, New Orleans, LA.
Abstract
BACKGROUND: Bilateral acute uveitis can cause significant morbidity, and a complete workup is often warranted. This report illustrates a case of sarcoid uveitis definitively diagnosed by skin biopsy in a patient with red tattoo ink. CASE REPORT: A 40-year-old African American male presented with bilateral photophobia and intraocular pressures of 26 mmHg in both eyes, 1+ grade cell and flare in both eyes, and granulomatous (mutton fat) keratic precipitates in both eyes. Serum angiotensin-converting enzyme level was elevated at 146 U/mL (normal value <40 U/mL), and computed tomography imaging revealed mediastinal and hilar lymphadenopathy. Multifocal induration and elevation in the areas of red pigment of a tattoo were also present and on punch biopsy revealed noncaseating granulomas, confirming the diagnosis of sarcoid uveitis. CONCLUSION: Our case suggests that a complete physical examination and inquiry about the presence of any tattoos should be conducted as part of the workup of uveitis.
BACKGROUND: Bilateral acute uveitis can cause significant morbidity, and a complete workup is often warranted. This report illustrates a case of sarcoid uveitis definitively diagnosed by skin biopsy in a patient with red tattoo ink. CASE REPORT: A 40-year-old African American male presented with bilateral photophobia and intraocular pressures of 26 mmHg in both eyes, 1+ grade cell and flare in both eyes, and granulomatous (mutton fat) keratic precipitates in both eyes. Serum angiotensin-converting enzyme level was elevated at 146 U/mL (normal value <40 U/mL), and computed tomography imaging revealed mediastinal and hilar lymphadenopathy. Multifocal induration and elevation in the areas of red pigment of a tattoo were also present and on punch biopsy revealed noncaseating granulomas, confirming the diagnosis of sarcoid uveitis. CONCLUSION: Our case suggests that a complete physical examination and inquiry about the presence of any tattoos should be conducted as part of the workup of uveitis.
Authors: Alvin S Teirstein; Marc A Judson; Robert P Baughman; Milton D Rossman; Henry Yeager; David R Moller Journal: Sarcoidosis Vasc Diffuse Lung Dis Date: 2005-06 Impact factor: 0.670
Authors: Kelly M Bui; Jose M Garcia-Gonzalez; Sarju S Patel; Amy Y Lin; Deepak P Edward; Debra A Goldstein Journal: J Ophthalmic Inflamm Infect Date: 2014-03-18