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nida
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06/16/06 - 07:08 PM       #1

A 27-year-old female presents to the emergency department for evaluation of a painful red left eye. The redness began late in the afternoon. She notes pain when looking at bright lights. The patient has had no viral symptoms or fevers but recently has noticed dyspnea with exertion and a dry cough. She was treated for a single episode of acute cystitis 10 weeks ago. Slit-lamp examination of the eye shows inflammation in the aqueous humor and inflammatory deposits on the corneal epithelium. Head and neck examination shows lymphadenopathy. There are a few dry crackles at the bases. Occasional wheezes are heard. There is no joint inflammation. Pulmonary function tests show a combined obstructive and restrictive defect. The diagnosis of this patient's eye disease is determined to be uveitis.
What is the most likely underlying disorder?
A. Ankylosing spondylitis
B. Inflammatory bowel disease
C. Reiter's syndrome
D. Sarcoidosis
E. Sjögren's syndrome


achilles
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06/16/06 - 07:28 PM       #2

d-sarcoidosis.

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MAZI
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06/16/06 - 09:21 PM       #3

sarcoidosis


karusmle
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06/17/06 - 02:25 AM       #4

sarcoidosis

mesh
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06/17/06 - 07:32 AM       #5

D

aml
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06/17/06 - 08:52 AM       #6

D= Sarcoidosis

nida
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06/17/06 - 12:27 PM       #7

D. Sarcoidosis is the right answer.

This patient has evidence of anterior uveitis that is associated with sarcoidosis. Anterior uveitis is usually marked by the abrupt onset of pain and photophobia. Specifically anterior uveitis causes iritis and iridocyclitis. Constriction of the pupil causes increased pain. Slit-lamp examination is diagnostic, showing inflammatory cells in the aqueous humor or deposited along the corneal endothelium. These deposits on the corneal endothelium are called keratic precipitates. Many diseases are associated with anterior uveitis, including sarcoidosis and the seronegative spondyloarthropathies, including ankylosing spondylitis, psoriasis, inflammatory bowel disease, and Behçet's disease. Infectious disease may also cause uveitis. Some of the associated infections include herpesviruses, tuberculosis, onchocerciasis, and leprosy. In the majority of cases, uveitis is idiopathic. Treatment should include topical corticosteroids to decrease inflammation and mydriatics because dilation of the pupil decreases pain and the formation of synechiae.

(Q -From Harrison)

achilles
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06/17/06 - 02:19 PM       #8

good question nida. pls keep posting more. thanks.

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