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Vasculitis-like hemorrhagic retinal angiopathy in Wegener’s granulomatosis

Please always quote using this URN: urn:nbn:de:bvb:20-opus-128744
  • Background: Granulomatosis with polyangiitis, also known as Wegener’s granulomatosis, is a chronic systemic inflammatory disease that can also involve the eyes. We report a case of massive retinal and preretinal hemorrhages with perivascular changes as the initial signs in granulomatosis with polyangiitis (Wegener’s granulomatosis). Case presentation: A 39-year-old Caucasian male presented with blurred vision in his right eye, myalgia and arthralgia, recurrent nose bleeds and anosmia. Fundus image of his right eye showed massive retinalBackground: Granulomatosis with polyangiitis, also known as Wegener’s granulomatosis, is a chronic systemic inflammatory disease that can also involve the eyes. We report a case of massive retinal and preretinal hemorrhages with perivascular changes as the initial signs in granulomatosis with polyangiitis (Wegener’s granulomatosis). Case presentation: A 39-year-old Caucasian male presented with blurred vision in his right eye, myalgia and arthralgia, recurrent nose bleeds and anosmia. Fundus image of his right eye showed massive retinal hemorrhages and vasculitis-like angiopathy, although no fluorescein extravasation was present in fluorescein angiography. Laboratory investigations revealed an inflammation with increased C-reactive protein, elevated erythrocyte sedimentation rate and neutrophil count. Tests for antineutrophil cytoplasmic antibodies (ANCA) were positive for c-ANCA (cytoplasmatic ANCA) and PR3-ANCA (proteinase 3-ANCA). Renal biopsy demonstrated a focal segmental necrotizing glomerulonephritis. Granulomatosis with polyangiitis (Wegener’s granulomatosis) was diagnosed and a combined systemic therapy of cyclophosphamide and corticosteroids was initiated. During 3 months of follow-up, complete resorption of retinal hemorrhages was seen and general complaints as well as visual acuity improved during therapy. Conclusion: Vasculitis-like retinal changes can occur in Wegener’s granulomatosis. Despite massive retinal and preretinal hemorrhages that cause visual impairment, immunosuppressive therapy can improve ocular symptoms.show moreshow less

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Metadaten
Author: Juliane Matlach, Florentina J. Freiberg, Ottar Gadeholt, Winfried Göbel
URN:urn:nbn:de:bvb:20-opus-128744
Document Type:Journal article
Faculties:Medizinische Fakultät / Augenklinik und Poliklinik
Language:English
Parent Title (English):BMC Research Notes
Year of Completion:2013
Volume:6
Issue:364
Source:BMC Research Notes 2013, 6:364. doi:10.1186/1756-0500-6-364
DOI:https://doi.org/10.1186/1756-0500-6-364
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:Wegener’s granulomatosis; cyclophosphamide; granulomatosis with polyangiitis; hemorrhages; retinal vasculitis
Release Date:2016/04/05
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung