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TitreFrosted branch angiitis associated with Epstein-Barr virus infection
ButFrosted vasculitis is a rare condition commonly associated with retinal vessel vasculitis and perivascular frosting. We report a rare case of bilateral frosted vasculitis in a young man, which revealed an Epstein-Barr virus infection.
MéthodesA 23-year-old man presented to our department with a rapidly progressive decreased visual acuity and floaters, associated to sore throat and gastroenteritis 10 days before. Visual acuity was 20/25 in both eyes and intraocular pressure was normal. There was no anterior segment inflammation and a mild hyalitis. Fundus examination revealed symmetrical frosted angiitis, scattered Roth spots, and moderate papillitis. OCT showed inner layers hyperreflectivity due to the ischemic retinal edema. Probabilistic antiviral treatment was initiated and anterior chamber tap was carried out looking for herpes family virus and toxoplasmosis. A 3-day intravenous methylprednisolone pulse therapy was introduced 48 hours later. Etiological work-up showed showed EBV serology negative for IgG and positive for IgM, and positive serum and aqueous humor EBV PCR
RésultatsEBV-related ophthalmological involvement is rare. In our case report, the patient presented with an EBV primary infection associated with a typical frosted angiitis clinical presentation: sore throat, gastroenteritis, hepatosplenomegaly, positive IgM antibodies during acute phase and positive blood PCR confirmed the systemic infection.Only two cases of EBV associated with frosted angiitis were described with none finding positive EBV PCR in aqueous humor and blood.
ConclusionEBV is a rare etiology of frosted angiitis in children and young adults but should be considered in patients presenting with the typical clinical manifestations by performing PCR in aqueous humor.
Conflit d'intérêtNon
Auteurs 1
InitialesA
NomNAJIB
InstitutUniversity Hospital of Rouen
VilleRouen
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