David S Curragh1, Clara E McAvoy2, Madeleine Rooney3, Eibhlin McLoone2. 1. Department of Ophthalmology, Royal Victoria Hospital, 274 Grosvenor Road, BT12 6BA, Belfast, UK. davidcurragh@hotmail.com. 2. Department of Ophthalmology, Royal Victoria Hospital, 274 Grosvenor Road, BT12 6BA, Belfast, UK. 3. Centre for Experimental Medicine, Queens University of Belfast, BT9 7BL, Belfast, UK.
Abstract
BACKGROUND/ OBJECTIVES: Uveitis is an uncommon manifestation of post-streptococcal syndrome (PSUS). Despite reports, the condition is often not well recognised. The purpose of this study is to report a case series of children with post-streptococcal uveitis. SUBJECTS/ METHODS: In this retrospective case series, all cases of PSUS were identified from all new paediatric patients diagnosed with uveitis over a 6-year period. Diagnosis of PSUS was based on the following diagnostic criteria: unilateral or bilateral uveitis with positive anti-streptolysin O titres (ASOT) or anti-deoxyribonuclease (anti-DNase) titres, and negative routine investigations for other causes of uveitis. RESULTS: Eleven Caucasian paediatric patients were diagnosed with PSUS. One had a novel finding of peripheral corneal endotheliopathy, 73% of patients presented in spring or winter months and 88% of eyes had a final VA of better than or equal to 6/12 at a mean follow-up of 22 months. Systemic immunosuppressant treatment was used in 36% of patients. Adalimumab was used in 18% of patient's refractory to other treatment. CONCLUSIONS: We report on the largest consecutive series of Caucasian patients under 16 years of age with PSUS. We have demonstrated a seasonal preponderance with presentation typically in winter or spring. We report a novel finding of corneal endotheliopathy in one of our PSUS patients. We also report on the benefit of adalimumab in the management of severe cases of PSUS; use of biologics in this particular cohort of uveitis patients has not previously been reported. With aggressive treatment our patients achieved good visual outcomes comparable to other published series.
BACKGROUND/ OBJECTIVES:Uveitis is an uncommon manifestation of post-streptococcal syndrome (PSUS). Despite reports, the condition is often not well recognised. The purpose of this study is to report a case series of children with post-streptococcal uveitis. SUBJECTS/ METHODS: In this retrospective case series, all cases of PSUS were identified from all new paediatric patients diagnosed with uveitis over a 6-year period. Diagnosis of PSUS was based on the following diagnostic criteria: unilateral or bilateral uveitis with positive anti-streptolysin O titres (ASOT) or anti-deoxyribonuclease (anti-DNase) titres, and negative routine investigations for other causes of uveitis. RESULTS: Eleven Caucasian paediatric patients were diagnosed with PSUS. One had a novel finding of peripheral corneal endotheliopathy, 73% of patients presented in spring or winter months and 88% of eyes had a final VA of better than or equal to 6/12 at a mean follow-up of 22 months. Systemic immunosuppressant treatment was used in 36% of patients. Adalimumab was used in 18% of patient's refractory to other treatment. CONCLUSIONS: We report on the largest consecutive series of Caucasian patients under 16 years of age with PSUS. We have demonstrated a seasonal preponderance with presentation typically in winter or spring. We report a novel finding of corneal endotheliopathy in one of our PSUS patients. We also report on the benefit of adalimumab in the management of severe cases of PSUS; use of biologics in this particular cohort of uveitispatients has not previously been reported. With aggressive treatment our patients achieved good visual outcomes comparable to other published series.
Authors: Shafiq Ur Rehman; Seema Anand; Aravind Reddy; Oliver C Backhouse; Moin Mohamed; Ishtiyak Mahomed; Arthur D Atkins; Teifi James Journal: Ophthalmology Date: 2006-04 Impact factor: 12.079
Authors: Jonathan Duffy; Paige Marquez; Graça M Dores; Carmen Ng; John Su; Maria Cano; Silvia Perez-Vilar Journal: Open Forum Infect Dis Date: 2020-10-27 Impact factor: 3.835