Purpose: We aim to describe first case of papillophlebitis with uveitis and vasculitis in perinuclear-anti-neutrophilic-cytoplasmic antibody myeloperoxidase (p-ANCA-MPO) positive term pregnancy reported in INDIA and to underline the importance of disease which should be better known among ophthalmologist. Methods: A 32 years old women visited our outpatient with unilateral defective vision, running nose, multiple joint ache in 3rd trimester pregnancy. Slit lamp examination revealed unilateral non-granulomatous uveitis, papillophlebitis with vasculitis. She had a positive nasal necrotizing lesion confirmed on biopsy by pathologist and p-ANCA-MPO serology positive. In view of above she was referred to rheumatologist. Results: She was diagnosed with Wegener’s granulomatosis (WG) and advised immunosuppresive therapy. She was started on 15mgm/kg/pulse of cyclophosphamide as induction therapy along with steroids and azathioprine 50mgm which were continued for a year postpartum. Anterior uveitis was treated with topical steroids with good effect. The side effects were transitory cushingoid change in mother and growth retardation in the infant. Conclusion: Pappilophlebitis, uveitis and vasulitis may be so mild that they may not cause troubling symptoms and hence in case of term pregnancy with Wegeners granulomatosis as an underlying disease it is commonly underdiagnosed. Great co-operation between ophthalmologist and immunologist is extremely crucial for early diagnosis and initiation of therapy. WG tends to be a multi-organ disease with high rate of recurrences and relapses requiring constant follow up. Early diagnosis would introduce immunosuppressive therapy safeguarding the outcome of pregnancy and lives of mother and foetus.
| Published in | International Journal of Ophthalmology & Visual Science (Volume 5, Issue 4) |
| DOI | 10.11648/j.ijovs.20200504.13 |
| Page(s) | 101-105 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Papillophlebitis, Unilateral, Uveitis, Vasculitis, ANCA, MPO, Immunesuppression
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APA Style
Deepesh Arora, Kanika Gupta, Surabhi Verma, Dinesh Sharma. (2020). Papillophlebitis with Uveitis in MPO ANCA Associated Pregnancy. International Journal of Ophthalmology & Visual Science, 5(4), 101-105. https://doi.org/10.11648/j.ijovs.20200504.13
ACS Style
Deepesh Arora; Kanika Gupta; Surabhi Verma; Dinesh Sharma. Papillophlebitis with Uveitis in MPO ANCA Associated Pregnancy. Int. J. Ophthalmol. Vis. Sci. 2020, 5(4), 101-105. doi: 10.11648/j.ijovs.20200504.13
AMA Style
Deepesh Arora, Kanika Gupta, Surabhi Verma, Dinesh Sharma. Papillophlebitis with Uveitis in MPO ANCA Associated Pregnancy. Int J Ophthalmol Vis Sci. 2020;5(4):101-105. doi: 10.11648/j.ijovs.20200504.13
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Download@article{10.11648/j.ijovs.20200504.13,
author = {Deepesh Arora and Kanika Gupta and Surabhi Verma and Dinesh Sharma},
title = {Papillophlebitis with Uveitis in MPO ANCA Associated Pregnancy},
journal = {International Journal of Ophthalmology & Visual Science},
volume = {5},
number = {4},
pages = {101-105},
doi = {10.11648/j.ijovs.20200504.13},
url = {https://doi.org/10.11648/j.ijovs.20200504.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20200504.13},
abstract = {Purpose: We aim to describe first case of papillophlebitis with uveitis and vasculitis in perinuclear-anti-neutrophilic-cytoplasmic antibody myeloperoxidase (p-ANCA-MPO) positive term pregnancy reported in INDIA and to underline the importance of disease which should be better known among ophthalmologist. Methods: A 32 years old women visited our outpatient with unilateral defective vision, running nose, multiple joint ache in 3rd trimester pregnancy. Slit lamp examination revealed unilateral non-granulomatous uveitis, papillophlebitis with vasculitis. She had a positive nasal necrotizing lesion confirmed on biopsy by pathologist and p-ANCA-MPO serology positive. In view of above she was referred to rheumatologist. Results: She was diagnosed with Wegener’s granulomatosis (WG) and advised immunosuppresive therapy. She was started on 15mgm/kg/pulse of cyclophosphamide as induction therapy along with steroids and azathioprine 50mgm which were continued for a year postpartum. Anterior uveitis was treated with topical steroids with good effect. The side effects were transitory cushingoid change in mother and growth retardation in the infant. Conclusion: Pappilophlebitis, uveitis and vasulitis may be so mild that they may not cause troubling symptoms and hence in case of term pregnancy with Wegeners granulomatosis as an underlying disease it is commonly underdiagnosed. Great co-operation between ophthalmologist and immunologist is extremely crucial for early diagnosis and initiation of therapy. WG tends to be a multi-organ disease with high rate of recurrences and relapses requiring constant follow up. Early diagnosis would introduce immunosuppressive therapy safeguarding the outcome of pregnancy and lives of mother and foetus.},
year = {2020}
}
TY - JOUR T1 - Papillophlebitis with Uveitis in MPO ANCA Associated Pregnancy AU - Deepesh Arora AU - Kanika Gupta AU - Surabhi Verma AU - Dinesh Sharma Y1 - 2020/12/22 PY - 2020 N1 - https://doi.org/10.11648/j.ijovs.20200504.13 DO - 10.11648/j.ijovs.20200504.13 T2 - International Journal of Ophthalmology & Visual Science JF - International Journal of Ophthalmology & Visual Science JO - International Journal of Ophthalmology & Visual Science SP - 101 EP - 105 PB - Science Publishing Group SN - 2637-3858 UR - https://doi.org/10.11648/j.ijovs.20200504.13 AB - Purpose: We aim to describe first case of papillophlebitis with uveitis and vasculitis in perinuclear-anti-neutrophilic-cytoplasmic antibody myeloperoxidase (p-ANCA-MPO) positive term pregnancy reported in INDIA and to underline the importance of disease which should be better known among ophthalmologist. Methods: A 32 years old women visited our outpatient with unilateral defective vision, running nose, multiple joint ache in 3rd trimester pregnancy. Slit lamp examination revealed unilateral non-granulomatous uveitis, papillophlebitis with vasculitis. She had a positive nasal necrotizing lesion confirmed on biopsy by pathologist and p-ANCA-MPO serology positive. In view of above she was referred to rheumatologist. Results: She was diagnosed with Wegener’s granulomatosis (WG) and advised immunosuppresive therapy. She was started on 15mgm/kg/pulse of cyclophosphamide as induction therapy along with steroids and azathioprine 50mgm which were continued for a year postpartum. Anterior uveitis was treated with topical steroids with good effect. The side effects were transitory cushingoid change in mother and growth retardation in the infant. Conclusion: Pappilophlebitis, uveitis and vasulitis may be so mild that they may not cause troubling symptoms and hence in case of term pregnancy with Wegeners granulomatosis as an underlying disease it is commonly underdiagnosed. Great co-operation between ophthalmologist and immunologist is extremely crucial for early diagnosis and initiation of therapy. WG tends to be a multi-organ disease with high rate of recurrences and relapses requiring constant follow up. Early diagnosis would introduce immunosuppressive therapy safeguarding the outcome of pregnancy and lives of mother and foetus. VL - 5 IS - 4 ER -
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