Lina Ma1,2,3, Stacey Lee1,2, Alyssa Montieth1,2, Andrew Stephenson1,2, C Stephen Foster1,2,4, Stephen D Anesi1,2. 1. Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts. 2. Ocular Immunology & Uveitis Foundation, Waltham, Massachusetts. 3. Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; and. 4. Harvard Medical School, Boston, Massachusetts.
Abstract
PURPOSE: To report a case of uveitis and papillitis in a patient with cryopyrin-associated periodic syndrome. METHODS: Case report. A 44-year-old white woman with a long history of inflammatory arthritis, diffuse erythematous rashes and hives, and hearing loss was referred to the Massachusetts Eye Research and Surgery Institution for an evaluation of chronic ocular inflammation. She was diagnosed with bilateral papillitis and uveitis after a comprehensive eye examination, which included dilated fundoscopy, optic nerve ocular coherence tomography, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography. She was later diagnosed with cryopyrin-associated periodic syndrome, an interleukin-1-driven autoimmune disease, as confirmed by genetic testing. Soon after starting treatment with anakinra, a human interleukin-1 receptor antagonist, she experienced rapid improvement of her ocular and systemic symptoms, including rash, uveitis, and arthritis. RESULTS: Cryopyrin-associated periodic syndrome-associated ocular inflammation in remission with anakinra 100-mg daily subcutaneous injection. CONCLUSION: Anakinra is a very effective treatment for both cryopyrin-associated periodic syndrome and cryopyrin-associated periodic syndrome-associated ocular inflammation.
PURPOSE: To report a case of uveitis and papillitis in a patient with cryopyrin-associatedperiodic syndrome. METHODS: Case report. A 44-year-old white woman with a long history of inflammatory arthritis, diffuse erythematous rashes and hives, and hearing loss was referred to the Massachusetts Eye Research and Surgery Institution for an evaluation of chronic ocular inflammation. She was diagnosed with bilateral papillitis and uveitis after a comprehensive eye examination, which included dilated fundoscopy, optic nerve ocular coherence tomography, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography. She was later diagnosed with cryopyrin-associatedperiodic syndrome, an interleukin-1-driven autoimmune disease, as confirmed by genetic testing. Soon after starting treatment with anakinra, a humaninterleukin-1 receptor antagonist, she experienced rapid improvement of her ocular and systemic symptoms, including rash, uveitis, and arthritis. RESULTS:Cryopyrin-associatedperiodic syndrome-associatedocular inflammation in remission with anakinra 100-mg daily subcutaneous injection. CONCLUSION: Anakinra is a very effective treatment for both cryopyrin-associatedperiodic syndrome and cryopyrin-associatedperiodic syndrome-associatedocular inflammation.