Viral Acute Anterior Uveitis: Clinical Signs Useful for Differential Diagnosis

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

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HLA-B27 frequency in Greek patients with acute anterior uveitis.

British Journal of Ophthalmology ◽

10.1136/bjo.61.11.699 ◽

1977 ◽

Vol 61 (11) ◽

pp. 699-701 ◽

Cited By ~ 15

Author(s):

J Zervas ◽

G Tsokos ◽

G Papadakis ◽

E Kabouklis ◽

D Papadopoulos

Keyword(s):

Anterior Uveitis ◽

Hla B27 ◽

Acute Anterior Uveitis

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Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02923-9 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Sebastian Ganz ◽

Axel Wehrend

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

Luteinizing Hormone ◽

Clinical Signs ◽

Menopausal Symptoms ◽

Case Presentation ◽

Estrogen Exposure ◽

Exogenous Estrogen ◽

Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

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The acute phase response protein SERPINA3 is increased in tear fluid from the unaffected eyes of patients with unilateral acute anterior uveitis

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00249-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jon Roger Eidet ◽

Maja Akopian ◽

Ole K. Olstad ◽

Øystein Kalsnes Jørstad ◽

Morten C. Moe ◽

...

Keyword(s):

Acute Phase ◽

Anterior Uveitis ◽

Acute Phase Response ◽

Phase Response ◽

Tear Fluid ◽

Enzyme Linked Immunosorbent Assay ◽

Healthy Controls ◽

Bacterial Keratitis ◽

Acute Anterior Uveitis ◽

Potential Biomarker

Abstract Background To identify candidate tear fluid biomarkers in patients with unilateral acute anterior uveitis (AAU) that can aid in the differentiation between these patients and patients with bacterial keratitis or healthy controls. Methods Thirteen patients (40.1 ± 16.2 years of age) with unilateral AAU, seven patients with unilateral bacterial keratitis (40.2 ± 15.3 years of age), and 14 healthy subjects (41.1 ± 11.6 years of age) were included. The tear proteome of affected eyes was compared with that of the unaffected eye or healthy controls. Proteins were identified by liquid chromatography tandem mass spectrometry and enzyme-linked immunosorbent assay. Results Relative protein ratios were detected and calculated for 272 unique proteins. Compared with healthy controls and the unaffected eye, the top upregulated proteins in AAU eyes were submaxillary gland androgen regulated protein 3B (SMR3B) and SMR3A. Similarly, the top upregulated proteins in bacterial keratitis were S100 calcium-binding protein A9 and orosomucoid 2. The acute phase response protein Serpin Family A Member 3 (SERPINA3) was increased in the healthy eye of AAU patients (P = 0.019) compared with healthy controls. Laser flare measurements in affected eyes of AAU patients showed positive logarithmic correlation with SERPINA3 in tear samples of the unaffected eye (P = 0.022). The use of SERPINA3 as a tear biomarker yielded a sensitivity of 85% and a specificity of 71% in detecting patients with AAU in the study population. Conclusions The acute phase response protein SERPINA3 was increased in tear samples of unaffected eyes of patients with unilateral AAU compared with healthy controls. This study highlights SERPINA3 as a potential biomarker for AAU. Future research should explore the dynamic properties of SERPINA3 in the tear fluid of active and quiescent uveitis eyes.

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