Human T-lymphotropic virus type I uveitis after Graves' disease

我们的血清流行病学、临床和病毒学数据使我们得出结论，HTLV-I与某种类型的葡萄膜炎密切相关，并且这种疾病是一种独特的临床实体。虽然HTLV-I感染细胞的作用和眼内组织受影响的机制尚不清楚，但由HTLV-I感染细胞介导的自身免疫机制很可能具有重要作用。主诉为视力模糊或飞蚊症，急性或亚急性起病。最典型的眼部发现是与轻度虹膜炎和轻度视网膜血管炎相关的玻璃体混浊。1989年1月至1992年4月，我们观察了93例HTLV-Ⅰ型葡萄膜炎患者，发现Graves病与HTLV-Ⅰ型葡萄膜炎有明显的相关性。93例HTLV-I葡萄膜炎患者中有16例（17.2%）既往有Graves病病史。女性15例（15/60，25.%）男性1例（1/33，3.0%）。有趣的是，所有病例的葡萄膜炎都发生在Graves病发作后。另一方面，222例HTLV-I血清阴性的特发性葡萄膜炎患者中无一例有Graves病病史。虽然HTLV-I引起葡萄膜炎和Graves病之间相关性的机制尚不清楚，但目前的数据表明，免疫介导的或自身免疫机制参与HTLV-I葡萄膜炎。

Our seroepidemiological, clinical, and virological data have led us to conclude that HTLV-I is closely associated with a certain type of uveitis, and that this disorder is a distinct clinical entity. Although the role of HTLV-I-infected cells and the mechanism by which the intraocular tissues are affected are unknown, it is highly likely that an autoimmune mechanism mediated by HTLV-I-infected cells has an important role.HTLV-I uveitis has several characteristic clinical features. The chief complaints are blurring of vision or floaters with acute or subacute onset. the most characteristic ocular findings are vitreous opacities associated with mild iritis and mild retinal vasculitis. Inflammation was reduced by treatment with topical or systemic corticosteroids, but recurred in about 60% of patients when therapy was discontinued.During the period between January 1989 and April 1992,93 patients were observed with HTLV-I uveitis and a significant correlation was found between Graves'disease and HTLV-I uveitis. Sixteen of the 93 patients with HTLV-I uveitis (17.2%) had a previous history of Graves' disease. Fifteen patients were female (15/60,25.%) and one was male(1/33,3.0%). Interestingly, uveitis occurred after the onset of Graves'disease in all cases. On the other hand, none of 222 patients with idiopathic uveitis who were seronegative to HTLV-I had a history of Graves'disease. Although the mechanisms by which HTLV-I causes the correlation between uveitis and Graves'disease are unknown, the present data suggest that immune mediated or autoimmune mechanisms are involved in HTLV-I uveitis.