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TitleRetinal vasculitis: a challenging case
PurposeTo report a diagnostic pitfall in a case of retinal vasculitis
Methods: Observational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
MethodsObservational report of a Caucasian male diagnosed as Behçet’s disease (BD), presenting with a branch retinal artery occlusion.
ResultsA 25-year-old man presented with unilateral vision loss. He presented with a trace of cells, a superior branch retinal artery occlusion, vasculitis and macular edema. In his antecedents he reported a deep vein thrombosis (DVT), the presence of pretibial subcutaneous nodules and positive genotyping of B51. BD was diagnosed. Although suggestive, the criteria for BD were not fulfilled. The ocular arterial occlusion with low grade inflammation, the history of orchitis, the normal renal function, the negative ANCA’s and the biopsy proven cutaneous vasculitis of medium-sized arteries, fit well with the diagnosis of PAN. The treatment is based on the use of systemic steroids and immunosuppressants, primarily azathioprine. However, some cases are refractory to this treatment and respond well to biologics.
ConclusionPAN is a necrotizing vasculitis of medium-sized arteries. BD is a systemic vasculitis that involves arteries and veins of any size. The diagnosis of BD is only supported by clinical criteria. Although HLA-B51 is a strongly associated risk factor for BD, there are no pathognomonic laboratorial findings of BD. Ocular vasculitic syndromes require a multidisciplinary approach and the exclusion of other diagnoses based on clinical presentation.
Conflict of interestNo
Authors 1
Last nameJADNANANSING
InitialsA
DepartmentFaculty of Medicine, Ghent University
CityGhent
Authors 2
Last nameTERRYN
InitialsW
DepartmentDepartment of Nephrology, Jan Yperman Hospital
CityIeper
Authors 3
Last nameSTOCKMAN
InitialsA
DepartmentDepartment of Dermatology, AZ Delta Hospital
CityRoeselare
Authors 4
Last nameDE SCHRYVER
InitialsI
DepartmentDepartment of Ophthalmology, Ghent University Hospital
CityGhent
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