RESUMO
Systemic lupus erythematosus (SLE) may affect the eyes and/or visual system in up to a third of patients; however, optic nerve involvement has been rarely reported. SLE presenting as optic neuropathy is exceptional. We report two new cases of optic neuropathy as a presenting feature of SLE. The first patient presented with an ischemic optic neuropathy and antiphospholipid antibodies, and the second presented with optic neuritis. A literature review for previous cases of SLE presenting as optic neuropathy was performed. Early diagnosis of SLE-associated optic neuropathy is warranted and leads to a better prognosis.
Assuntos
Lúpus Eritematoso Sistêmico/complicações , Doenças do Nervo Óptico/etiologia , Corticosteroides/uso terapêutico , Adulto , Anticorpos Antifosfolipídeos/sangue , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/tratamento farmacológico , Neurite Óptica/etiologia , Neuropatia Óptica Isquêmica/etiologia , Adulto JovemRESUMO
INTRODUCTION: Pseudoxanthoma elasticum is a congenital dystrophy of the connective tissue. Its clinical expression is cutaneous, ocular and cardiovascular. PATIENTS AND METHODS: The aim of our study was to specify the principle characteristics of this disease and to discuss the interest of various supplementary examinations in its diagnosis and control in a series of 11 patients. RESULTS: The study included 9 women and 2 men (sex ratio: 4.5). The mean age the onset of the symptoms was of 18 years. In 4 cases there was a family history of the disease. All the patients exhibited yellowish, pigskin, and papular lesions on the sides of the neck. The systematic ophthalmologic examination revealed angioid streaks in 7 cases and a pigskin aspect in 4 cases. The systematic cardiovascular and metabolic explorations revealed no abnormalities specific to pseudoxanthoma elasticum. Two cases of asymptomatic nephrocalcinosis were observed. DISCUSSION: In our patients, the disease was probably of autosomal recessive transmission. The predominance of women consulting for the disease would be explained by the esthetic damage. Diagnosis of pseudoxanthoma elasticum is based on clinical, histological and genetic criteria. Supplementary explorations are useful to confirm the diagnosis and also for the search to other, visceral, localizations. Such examinations vary depending on the teams, means and above all the evocative signs.
