Bilateral granulomatous panuveitis in two patients with T-cell type of chronic active Epstein-Barr virus infection
Bilateral granulomatous panuveitis in two patients with T-cell type of chronic active Epstein-Barr virus infection
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DOI：
10.1186/s12886-019-1090-5
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发表时间：
2019-03-29
影响因子：
2
通讯作者：
Ohno-Matsui, Kyoko
中科院分区：
文献类型：
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作者：
Takahashi, Hiroyuki;Takase, Hiroshi;Ohno-Matsui, Kyoko
报告2例双侧肉芽肿性全葡萄膜炎合并慢性活动性EB病毒感染（CAEBV）病例资料病例1为38岁男性，有双侧轻度全葡萄膜炎病史，诊断为CAEBV感染。15个月后，出现严重的双侧肉芽肿性全葡萄膜炎。右眼视盘及视网膜血管均为白色浸润，左眼视网膜静脉及动脉均为沿着分布的白色结节。例2为一34岁男性，双眼全葡萄膜炎，表现为羊脂样角膜沉淀物和弥漫性玻璃体混浊。右眼存在雪球样玻璃体混浊。系统调查显示存在CAEBV。在这两种情况下，一个全面的聚合酶链反应（PCR）分析的房水检测到显着的EBV-DNA拷贝数。眼内炎症没有反应类固醇，甲氨蝶呤，和其他免疫抑制剂治疗，但改善造血干细胞移植前化疗和低剂量全身照射在这两种cases.ConclusionGranulomatous全葡萄膜炎可以开发的眼睛与CAEBV作为一个主要症状。当EBV-DNA在类固醇抵抗性全葡萄膜炎的眼内液中呈阳性时，眼科医生应排除CAEBV。
BackgroundTo report 2 cases of bilateral granulomatous panuveitis accompanied by chronic active Epstein-Barr virus infection (CAEBV).Case presentationCase 1 was a 38-year-old man who had a history of bilateral mild panuveitis who was diagnosed with CAEBV. Fifteen months later, a severe bilateral granulomatous panuveitis developed. White infiltrates covered the optic disc and all the retinal vessels of the right eye, and white nodules were seen along the retinal veins and arteries of the left eye. Case 2 was a 34-year-old man with bilateral panuveitis showing mutton-fat keratic precipitates and diffuse vitreous opacity in both eyes. A snow ball-like vitreous opacity was present in the right eye. Systemic investigations revealed the presence of CAEBV. In both cases, a comprehensive polymerase chain reaction (PCR) analyses of the aqueous humor detected significant copy numbers of EBV-DNA. The intraocular inflammation did not respond to steroid, methotrexate, and other immunosuppressive therapies, but was ameliorated after hematopoietic stem cell transplantation with preceding chemotherapy and low-dose total body irradiation in both cases.ConclusionGranulomatous panuveitis can develop in eyes with CAEBV as a primary symptom. Ophthalmologists should rule out CAEBV when EBV-DNA is positive in the intraocular fluids of steroid-resistant panuveitis.