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Current Opinion in Rheumatology Jan 2024Epidemiology of vasculitides exhibit geographic variation and data from some parts of the world are still scarce. Increased recognition of these rare diseases and... (Review)
Review
PURPOSE OF REVIEW
Epidemiology of vasculitides exhibit geographic variation and data from some parts of the world are still scarce. Increased recognition of these rare diseases and improvement in diagnosis and patient care may lead to changes in their epidemiology. In this review, we aimed to highlight the most recent work on the epidemiology of systemic vasculitis.
RECENT FINDINGS
New data from countries where information on the epidemiology of giant cell arteritis, Takayasu arteritis and Behçet syndrome were limited have revealed that these conditions are not as rare as previously believed. The incidence rates during the coronavirus disease 2019 pandemic highlight the link between Kawasaki disease and respiratory pathogens. The use of different classification criteria hampers the comparison of true incidence and prevalence rates in antineutophil cytoplasmic antibody (ANCA)-associated vasculitis and its subtypes between geographies and over time.
SUMMARY
Recent studies have highlighted the epidemiology of vasculitides in different parts of the world and changing trends. Standardization of study design and disease definitions is needed to improve the reliability and comparability of the results.
Topics: Humans; Reproducibility of Results; Systemic Vasculitis; Mucocutaneous Lymph Node Syndrome; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Giant Cell Arteritis; Behcet Syndrome; Takayasu Arteritis
PubMed: 37800639
DOI: 10.1097/BOR.0000000000000983 -
Journal Francais D'ophtalmologie Sep 2023To evaluate the ophthalmological findings in patients diagnosed with acute, subacute or chronic brucellosis and to determine the effects of this disease on ocular...
PURPOSE
To evaluate the ophthalmological findings in patients diagnosed with acute, subacute or chronic brucellosis and to determine the effects of this disease on ocular structures.
METHODS
Eighty-seven patients diagnosed with brucellosis and 71 healthy cases (as a control group) were enrolled in this prospective study. All participants underwent a complete ophthalmic evaluation, including slit lamp biomicroscopic examination, Goldman applanation tonometry, specular microscopy, optical coherence tomography and fundoscopy with pupil dilation.
RESULTS
Overall, ocular involvement was present in 47 eyes of 27 (31.03%) patients diagnosed with brucellosis and was most common in the chronic brucellosis group. In the acute brucellosis group, papillary conjunctivitis in 8 eyes of 4 patients and anterior uveitis in 10 eyes of 6 patients were noted. In the subacute brucellosis group, papillary conjunctivitis in 4 eyes of 2 patients and sequelae of anterior uveitis in 6 eyes of 3 patients were observed. In the chronic brucellosis group, panuveitis in 4 eyes of 2 patients, choroiditis in 4 eyes of 2 patients, and signs of previous anterior uveitis in 11 eyes of 6 patients were noted. Visual acuity was significantly worse in patients with acute anterior uveitis (AAU) or previous anterior uveitis (PAU) compared with the control cases.
CONCLUSION
Ocular involvement should be kept in mind in patients with brucellosis, especially acute, and brucellosis should be included in the differential diagnosis of patients with anterior uveitis living in endemic areas, since the clinical presentation of the disease may not be overt.
Topics: Humans; Uveitis; Prospective Studies; Uveitis, Anterior; Conjunctivitis; Brucellosis; Retrospective Studies
PubMed: 37541801
DOI: 10.1016/j.jfo.2023.02.017 -
Ophthalmology Dec 2023
Topics: Humans; Suppuration; Uveitis, Anterior; Eye Abnormalities
PubMed: 36849294
DOI: 10.1016/j.ophtha.2023.01.018 -
Cornea Nov 2023The aim of this study was to describe the clinical features and management of uveitis associated with microsporidial keratoconjunctivitis (MKC).
OBJECTIVE
The aim of this study was to describe the clinical features and management of uveitis associated with microsporidial keratoconjunctivitis (MKC).
METHODS
The medical records of clinically diagnosed or microbiologically proven patients with MKC between July 2016 and August 2021 were reviewed. Patients with documented evidence of keratic precipitates (KPs) or anterior chamber cells were analyzed for their demography, clinical features, and treatment. Patients with microsporidial stromal keratitis and herpes simplex virus keratouveitis were excluded from the study.
RESULTS
Of the 2212 patients reviewed within the study period 171 of 172 eyes (7.7%) had documented evidence of KPs and/or anterior chamber cells. The patients' mean age was 43.8 ± 13.8 years, and there were more men (n = 120). The mean duration of appearance of KPs was 6.9 ± 5.5 days, and 28% (n = 48 of 171) appeared on the day of presentation. Superficial punctate keratitis was central and diffuse in 48 and 49 patients, respectively. The treatment was either lubricant alone (45.3%; 78 eyes) or combined with topical steroids (54.7%; 94 eyes). The mean duration of the resolution was longer in the "corticosteroid" than "no corticosteroid" group: KPs: 15.3 ± 6.5 days versus 12.3 ± 5.8 days ( P = 0.007) and superficial punctate keratitises: 15.4 ± 9.4 days versus 11.7 ± 6.2 days ( P = 0.01). The presenting visual acuity with a pinhole was 0.26 ± 0.26 (logMAR) and it improved to 0.03 ± 0.07 on resolution ( P < 0.0001, paired t test).
CONCLUSIONS
Uveitis after MKC is a self-limiting entity that often resolves without corticosteroid. One must exercise caution in using steroids in the presence of active corneal lesions.
Topics: Male; Humans; Adult; Middle Aged; Microsporidia; Microsporidiosis; Eye Infections, Fungal; Keratoconjunctivitis; Keratitis, Herpetic; Uveitis, Anterior; Uveitis; Steroids
PubMed: 36727968
DOI: 10.1097/ICO.0000000000003230 -
Clinical and Experimental Rheumatology Oct 2023The aim of this review was to describe the changes in the microbiota of patients with Behçet's disease (BD) and the mechanisms involved in the relationship between the... (Review)
Review
The aim of this review was to describe the changes in the microbiota of patients with Behçet's disease (BD) and the mechanisms involved in the relationship between the microbiome and immunity in BD. A systematic search for relevant articles was made on PubMed and the Cochrane Library database using the following terms: "microbiota AND Behçet's disease" or "microbiome AND Behçet's disease". Sixteen articles were included in a qualitative synthesis. This systematic review on the microbiome and Behçet's disease underlines the presence of gut dysbiosis in BD patients. This dysbiosis is marked by (i) a decrease in butyrate-producing bacteria, which could affect T cell differentiation and epigenetic regulation of immune-related genes, (ii) a modification of tryptophan-metabolising bacteria, which could be linked to dysregulated IL-22 secretion, and (iii) a decrease in bacteria known to have anti-inflammatory properties. Regarding oral microbiota, this review underlines the possible role of Streptococcus sanguinis through molecular mimicry and NETosis. Clinical studies of BD have shown that (i) need for dentistry is associated with a more severe course in BD, and (ii) antibiotic-supplemented mouthwash reduces pain and ulcers. Fecal transplantation of BD patients' microbiota into mouse models led to decreased SCFA production, neutrophil activation, and Th1/Th17 responses.Recipient mice showed exacerbated experimental autoimmune uveitis (EAU) and experimental autoimmune encephalomyelitis (EAE). In Herpes Virus Simplex-1 (HSV-1) infected mice mimicking BD, administration of butyrateproducing bacteria improved symptoms and immune variables. The microbiome may thus be involved in BD through immunity regulation and epigenetic modifications.
Topics: Humans; Animals; Mice; Behcet Syndrome; Dysbiosis; Epigenesis, Genetic; Uveitis; Microbiota; Bacteria
PubMed: 37382445
DOI: 10.55563/clinexprheumatol/zbt4gx -
Clinical Ophthalmology (Auckland, N.Z.) 2023Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare autoimmune disease with unclear pathogenesis but probably related to a combination of genetic... (Review)
Review
Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare autoimmune disease with unclear pathogenesis but probably related to a combination of genetic predisposition and environmental triggers. Diagnosis is challenging due to the asynchronous onset of renal and ocular symptoms, and it is necessary to exclude other causes of nephritis and uveitis. It affects both sexes, with an overall predominance of females and a median age of onset of 15 years. TINU syndrome is characterized by bilateral, non-granulomatous anterior uveitis and tubulointerstitial nephritis, which can cause acute renal failure in severe cases. Several triggers have been identified including concurrent infections, medications, or endocrine diseases. The diagnosis of TINU is mainly based on clinical and analytical findings, and although urinary β2-microglobulin is a useful parameter no specific diagnostic test is available. Current perspectives intend to facilitate its diagnosis identifying susceptibility HLA genotypes, serologic markers and imaging tools to avoid renal biopsy. Treatment options for TINU syndrome include corticosteroids, immunosuppressive agents, and intravenous immunoglobulins, but relapses are frequent, and management can be challenging. The purpose of this review is to provide an updated summary of the diagnostic and treatment strategies of TINU syndrome, helping clinicians recognize and manage this rare autoimmune disorder.
PubMed: 37701464
DOI: 10.2147/OPTH.S404644 -
Clinical Immunology (Orlando, Fla.) Sep 2023
Topics: Humans; Behcet Syndrome
PubMed: 37517564
DOI: 10.1016/j.clim.2023.109711 -
Medicina Clinica Aug 2023Analyse and describe the anatomical and etiological classification, clinical and epidemiological characteristics and most frequent symptoms of uveitis cases in our... (Observational Study)
Observational Study
PURPOSE
Analyse and describe the anatomical and etiological classification, clinical and epidemiological characteristics and most frequent symptoms of uveitis cases in our population.
PATIENTS AND METHOD
Descriptive, retrospective observational study of uveitis cases treated in the Ophthalmology Department of Virgen del Rocío University Hospital in 2021. The demographic and clinical characteristics were studied.
RESULTS
A total of 109cases of uveitis were studied, 46 men and 63 women, with a mean age of 45.43±16.11 years. The most frequent symptoms were pain (74.31%), hyperemia (73.39%) and blurred vision (65.14%). The most frequent anatomical classification was anterior (55.96%), followed by panuveitis (18.35%), posterior (12.84%) and intermediate uveitis (7.34%). Regarding etiology, most uveitis were idiopathic (42.99%), followed by non-infectious (38.32%) and finally infectious (18.69%).
CONCLUSIONS
In southern España, the characteristics of uveitis are similar to other studies in Western countries.
Topics: Male; Humans; Female; Adult; Middle Aged; Uveitis; Panuveitis; Retrospective Studies; Vision Disorders; Hospitals, University
PubMed: 37248128
DOI: 10.1016/j.medcli.2023.04.009