Desprendimiento de retina seroso con lupus fijo discoides y nefropatía por inmunoglobulina A / Serous retinal detachment in a patient with discoid fixed lupus and nephropathy by immunoglobulin A

El desprendimiento seroso de retina produce disminución de la agudeza visual debido al paso de fluido procedente de la coroides hacia el espacio subretiniano. Esta enfermedad tiene varias causas, entre las que se encuentran las idiopáticas, congénitas, posquirúrgicas, secundarias e uveítis infecciosas, autoinmune, vascular, hematológicas y neoplásicas.Objetivo: describir el caso inusual de un paciente joven con desprendimiento seroso de retina asociado a lupus fijo discoide y nefropatía por inmunoglobulina A con respuesta satisfactoria al uso de esteroides.Caso clínico: se presenta un paciente masculino de 18 años de edad que acudió a consulta de retina del centro oftalmológico del Hospital Universitario Manuel Ascunce Domenech, por disminución súbita de la agudeza visual en ambos ojos con diagnóstico inicial de coroidopatia serosa central, que posteriormente evolucionó hacia desprendimientos serosos bilaterales con afectación de todo el polo posterior. Por sus antecedentes se interconsultó con el especialista en dermatología y nefrología, donde se decidió iniciar tratamiento con esteroides a altas dosis, vitaminoterapia endovenosa, así como antiinflamatorios y midriáticos ciclopléjicos tópicos con respuesta excelente a la terapia (AU)

Serous retinal detachment causes visual acuity decrease due to the passage of fluid from the choroid into the subretinal space. This disease has several causes including idiopathic, congenital, postoperative, and secondary to infectious uveitis, autoimmune, vascular, hematological and neoplastic ones.Objective: to describe an unusual case of a young patient with serous retinal detachment associated with discoid fixed lupus and nephropathy by immunoglobulin A with satisfactory response to steroids use.Clinical case: a male patient of 18 years old was presented in the retina office of the Ophthalmological Center at the University Hospital Manuel Ascunce Domenech with sudden decrease of visual acuity in both eyes with an initial diagnosis of serous central choroidopathy, which later progressed into bilateral serous detachments with entire posterior pole involvement. By his antecedents, a specialty consultation in dermatology and nephrology was carried out, deciding to initiate treatment with high-dose steroids, intravenous vitamin therapy, and anti-inflammatory and topical cycloplegic mydriatic with excellent response to therapy (AU)

Desprendimiento de retina seroso con lupus fijo discoides y nefropatía por inmunoglobulina A / Serous retinal detachment in a patient with discoid fixed lupus and nephropathy by immunoglobulin A

El desprendimiento seroso de retina produce disminución de la agudeza visual debido al paso de fluido procedente de la coroides hacia el espacio subretiniano. Esta enfermedad tiene varias causas, entre las que se encuentran las idiopáticas, congénitas, posquirúrgicas, secundarias e uveítis infecciosas, autoinmune, vascular, hematológicas y neoplásicas.Objetivo: describir el caso inusual de un paciente joven con desprendimiento seroso de retina asociado a lupus fijo discoide y nefropatía por inmunoglobulina A con respuesta satisfactoria al uso de esteroides.Caso clínico: se presenta un paciente masculino de 18 años de edad que acudió a consulta de retina del centro oftalmológico del Hospital Universitario Manuel Ascunce Domenech, por disminución súbita de la agudeza visual en ambos ojos con diagnóstico inicial de coroidopatia serosa central, que posteriormente evolucionó hacia desprendimientos serosos bilaterales con afectación de todo el polo posterior. Por sus antecedentes se interconsultó con el especialista en dermatología y nefrología, donde se decidió iniciar tratamiento con esteroides a altas dosis, vitaminoterapia endovenosa, así como antiinflamatorios y midriáticos ciclopléjicos tópicos con respuesta excelente a la terapia

Serous retinal detachment causes visual acuity decrease due to the passage of fluid from the choroid into the subretinal space. This disease has several causes including idiopathic, congenital, postoperative, and secondary to infectious uveitis, autoimmune, vascular, hematological and neoplastic ones.Objective: to describe an unusual case of a young patient with serous retinal detachment associated with discoid fixed lupus and nephropathy by immunoglobulin A with satisfactory response to steroids use.Clinical case: a male patient of 18 years old was presented in the retina office of the Ophthalmological Center at the University Hospital Manuel Ascunce Domenech with sudden decrease of visual acuity in both eyes with an initial diagnosis of serous central choroidopathy, which later progressed into bilateral serous detachments with entire posterior pole involvement. By his antecedents, a specialty consultation in dermatology and nephrology was carried out, deciding to initiate treatment with high-dose steroids, intravenous vitamin therapy, and anti-inflammatory and topical cycloplegic mydriatic with excellent response to therapy

Conversion of discoid lupus to antiphospholipid syndrome and SLE.

BACKGROUND: A 64-year-old man was admitted to hospital with increasing seizure frequency, lethargy and confusion. He had a history of discoid lupus erythematosus, complex partial seizures, cerebral thromboses associated with antiphospholipid syndrome (APS) and hypertension. After admission to hospital, he developed autoimmune hemolytic anemia, thrombocytopenia, severe hypertension, proteinuria and a fluctuating level of consciousness. INVESTIGATIONS: Physical examination, biochemical and hematological indices, urine dipstick, electrocardiography and chest radiography on admission, with subsequent electroencephalography, lumbar puncture, septic screen, autoimmune screen, CT of the head, MRI of the brain and renal biopsy. DIAGNOSIS: Conversion of discoid lupus erythematosus with APS to systemic lupus erythematosus with APS. MANAGEMENT: Pulsed intravenous methylprednisolone and a single infusion of intravenous cyclophosphamide, followed by oral prednisolone, were initially administered for presumed cerebral lupus. When renal biopsy revealed dual pathology, another dose of intravenous cyclophosphamide was administered with intravenous heparin therapy to treat systemic lupus erythematosus and APS, respectively. Intravenous immunoglobulin was used to treat thrombocytopenia, which was unresponsive to immunosuppression and anticoagulation. Gradual improvement occurred with maximal antihypertensive therapy and supportive treatment. The patient was discharged after 9 months of hospital treatment. His medication at this stage included warfarin, clopidogrel, prednisolone, carbamazepine, ramipril, atenolol, calcium and vitamin D supplements, and alendronate.

Coexistence of osteopoikilosis and discoid lupus erythematosus: a case report.

Osteopoikilosis is an uncommon, benign sclerosing bone dysplasia characterised by typical roentgenographic findings and usually seen in patients with dermatological problems. We report a case of osteopoikilosis and discoid lupus erythematosus presenting with skin and mucosal involvement, an association that has never previously been reported. We also discuss the differential diagnosis and the clinical pathologies accompanying osteopoikilosis in the literature.