Clinical Manifestations of Patients With Intraocular Inflammation and Positive QuantiFERON-TB Gold In-Tube Test in a Country Nonendemic for Tuberculosis
Clinical Manifestations of Patients With Intraocular Inflammation and Positive QuantiFERON-TB Gold In-Tube Test in a Country Nonendemic for Tuberculosis
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DOI：
10.1016/j.ajo.2013.11.013
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发表时间：
2014-04-01
影响因子：
4.2
通讯作者：
Rothova, Aniki
中科院分区：
文献类型：
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作者：
Nora, Rina La Distia;van Velthoven, Miriam E. J.;Rothova, Aniki
目得：为了评估不明原因的葡萄膜炎和巩膜炎患者的临床表现和阳性QuantiFERON-TB金管试验（quantiferon）在一个国家没有地方性tuberculosis.DESIGN：多中心回顾性队列研究方法：回顾性回顾77例患者的临床，实验室和影像学资料。主要结果的措施，包括眼部和全身的功能，以及实验室检查的结果。结果：在所有的，60 71（85%）生活在结核病流行地区至少6个月。葡萄膜炎的位置是可变的;后葡萄膜炎（29/77; 38%）是最常见的。两种临床实体通常被注意到：视网膜闭塞性血管炎（21/77; 27%）和蛇形脉络膜炎（11/77; 14%）。32例患者完成了抗结核治疗，其中29例（91%）达到完全缓解。平均quantiferon水平为7.5 U/mL; 71%的值高于2 U/mL，41%的值高于10 U/mL。我们没有观察到quantiferon水平和临床和/或影像学特征之间的关联。77例患者中有5例（6.5%）诊断为既往结核感染，而76例患者中有25例（33%）发现肺门/纵隔淋巴结病。其中，12个是符合结节病的诊断，9个是典型的（以前）结核病，和4个是符合这两个diagnosis.CONCLUSIONS：特发性葡萄膜炎和阳性quantiferon患者的眼部特征是不同的，但视网膜阻塞性血管炎和蛇形脉络膜炎是常见的。quantiferon水平通常高度升高，33%的患者表现出淋巴结肿大，提示结节病的诊断。眼部炎症对抗结核治疗反应良好，尽管只有少数人有记录（先前）结核病。(C)2014年，Elsevier Inc. All rights reserved.
PURPOSE: To evaluate clinical manifestations of patients with uveitis and scleritis of unknown origin and positive QuantiFERON-TB Gold In-Tube test (quantiferon) in a country not endemic for tuberculosis.DESIGN: Multicenter retrospective cohort study.METHODS: Retrospective review of the clinical, laboratory, and imaging data of 77 patients. Main outcome measures consisted of ocular and systemic features as well as results of laboratory examinations.RESULTS: Out of all, 60 of 71 (85%) were living for at least 6 months in tuberculosis-endemic regions. Location of uveitis was variable; posterior uveitis (29/77; 38%) was the most frequent. Two clinical entities were commonly noted: retinal occlusive vasculitis (21/77; 27%) and serpiginoid choroiditis (11/77; 14%). Antituberculosis treatment was completed in 32 patients; 29 of them (91%) achieved complete remission. Mean quantiferon level was 7.5 U/mL; 71% had values above 2 U/mL and 41% above 10 U/mL. We observed no associations between quantiferon levels and clinical and/or imaging features. Previous tuberculosis infection was diagnosed in 5 of 77 patients (6.5%), while hilar/mediastinal lymphadenopathy was found in 25 of 76 patients (33%). Of these, 12 were consistent with the diagnosis of sarcoidosis, 9 were typical for (prior) tuberculosis, and 4 were compatible with both diagnoses.CONCLUSIONS: Ocular features of patients with idiopathic uveitis and positive quantiferon were diverse, but retinal occlusive vasculitis and serpiginoid choroiditis were common. The quantiferon levels were usually highly elevated and 33% of patients exhibited lymphadenopathy, suggesting frequently the diagnosis of sarcoidosis. Ocular inflammation reacted favorably to antituberculosis treatment, although only a small minority had documented (prior) tuberculosis. (C) 2014 by Elsevier Inc. All rights reserved.