Acute posterior multifocal placoid pigment epitheliopathy in connection with acute nephritis.

A relationship between acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and systemic infections has been suggested. This report presents a case of APMPPE in connection with acute nephritis in a previously healthy man. The disease started with arthralgia, headache, fever, malaise, and lymphadenopathy. During the following 2 weeks, signs of mild nephritis developed. At the same time the patient noticed acute decrease in vision; the visual acuity being 0.08 (20/250) in both eyes. Mild anterior uveitis and areas of pigment epithelial swelling at the posterior pole corresponding to the picture of APMPPE were observed. Four weeks later, the fundus lesions had healed leaving some pigment epithelial atrophy and pigment dispersion in the macula, and the visual acuity was 0.8 (20/25) in the right and 1.0 (20/20) in the left eye. No systemic therapy was given. This case gives support to the theory of general vasculitis as a cause of APMPPE.