IgG4-Related Ophthalmic Disease Presenting as Meningitis and Panuveitis
Joint Authors
Mavrommatis, Maria A.
Avila, Sarah A.
France, Richard
Source
Case Reports in Ophthalmological Medicine
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-07-15
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Purpose.
We report an uncommon case of immunoglobulin gamma 4-related ophthalmic disease (IgG4-ROD) presenting as meningitis and panuveitis.
Observations.
A 35-year-old male with no prior ophthalmic history presented with headaches, altered mental status, and fever of unknown origin.
A lumbar puncture (LP) revealed an elevated white count with lymphocytic predominance, confirming a suspected meningitis.
After an extensive work-up, he was discharged on oral acyclovir to cover for presumed aseptic meningitis.
The patient initially improved, however, bilateral eye pain, redness, and photophobia 2 weeks after discharge prompted his first visit to the ophthalmology clinic.
Exam at that time was consistent with bilateral anterior uveitis for which he was given topical prednisolone and cyclopentolate.
In addition to the preceding work-up, quantitative immunoglobulin serology including IgG4 levels was added.
At follow-up, he was found to have increased ocular inflammation with vitreitis, nerve head edema, and subclinical macular thickening.
Visual acuity (VA) had decreased in both eyes.
Serology titers for IgG had resulted in a significant elevation in IgG subclass 4 (IgG4).
Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) confirmed posterior retinal involvement.
The patient was diagnosed with presumed bilateral panuveitis secondary to IgG4-ROD.
Conclusions and Importance.
IgG4-RD can be a serious condition that requires careful consideration and intuition to diagnose.
This report serves to encourage ophthalmologists to consider IgG4-ROD in cases of idiopathic systemic inflammation with ophthalmic involvement.
American Psychological Association (APA)
Mavrommatis, Maria A.& Avila, Sarah A.& France, Richard. 2019. IgG4-Related Ophthalmic Disease Presenting as Meningitis and Panuveitis. Case Reports in Ophthalmological Medicine،Vol. 2019, no. 2019, pp.1-4.
https://search.emarefa.net/detail/BIM-1142320
Modern Language Association (MLA)
Mavrommatis, Maria A.…[et al.]. IgG4-Related Ophthalmic Disease Presenting as Meningitis and Panuveitis. Case Reports in Ophthalmological Medicine No. 2019 (2019), pp.1-4.
https://search.emarefa.net/detail/BIM-1142320
American Medical Association (AMA)
Mavrommatis, Maria A.& Avila, Sarah A.& France, Richard. IgG4-Related Ophthalmic Disease Presenting as Meningitis and Panuveitis. Case Reports in Ophthalmological Medicine. 2019. Vol. 2019, no. 2019, pp.1-4.
https://search.emarefa.net/detail/BIM-1142320
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1142320