The Utility of Routine Screening of Patients With Uveitis for Systemic Lupus Erythematosus or Tuberculosis

Rosenbaum, James T.; Wernick, Richard

doi:10.1001/archopht.1990.01070110107034

Cited by 75 publications

(30 citation statements)

References 17 publications

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“…The results herein described show that in a situation of high positive pretest probability, 35 QFN testing in chronic idiopathic posterior uveitides contributed to a better selection of patients for ATT, but was not useful for ATT-response monitoring. Although QFN performed better than Mantoux in terms of specificity and PPV, a negative QFN has to be interpreted with caution in patients under immunosuppression and patients with active TB as false QFN-negative exist, as described previously.…”

Section: Discussionmentioning

confidence: 77%

The value of an immune response to Mycobacterium tuberculosis in patients with chronic posterior uveitides revisited: utility of the new IGRAs

Cordero‐Coma

Calleja

Torres

et al. 2009

Eye

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Section: Discussionmentioning

confidence: 77%

The value of an immune response to Mycobacterium tuberculosis in patients with chronic posterior uveitides revisited: utility of the new IGRAs

Cordero‐Coma

Calleja

Torres

et al. 2009

Eye

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“…The predictive value varies depending on the population TB incidence and local BCG vaccination policy; in the United States, the routine use of TB skin testing in patients with uveitis is considered unhelpful 13 whereas in India it is considered mandatory. 8 In our study, excluding those with active TB all of our patients were Mantoux test positive 410 mm and in the context of any active uveitis without another defined aetiology, this should be considered important guidance.…”

Section: Discussionmentioning

confidence: 99%

Presumed tuberculous uveitis: diagnosis, management, and outcome

Sanghvi

Bell

Woodhead

et al. 2011

Eye

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Purpose To assess the effectiveness of anti-tuberculous treatment in patients with chronic uveitis and either active systemic or latent tuberculosis (TB) in a non-endemic community. Methods Retrospective study of patients with chronic uveitis, non-ocular evidence of latent or active TB and no other identified cause of uveitis who underwent a 6-month course of standard anti-tuberculous chemotherapy. Response to treatment was assessed at 6 and 12 months after initiation of treatment. Results A total of 27 patients were included of whom 59% were female. In all, 19 were Asian, 4 Caucasian, and 4 Black. More than half of patients had a history of contact with another person treated for TB. Inflammation resolved after chemotherapy in 70.3% of patients, 18.5% had a change in the nature of their inflammation and 11.1% had no benefit. Conclusions There were no uveitis features characteristic of TB uveitis and a wide range of manifestations was seen ranging from non-granulomatous anterior uveitis to occlusive retinal vasculitis. TB is not endemic in the United Kingdom, therefore consideration of ethnicity, immigration, and history of TB contact remain important to direct investigations. In a patient with uveitis and latent TB, a full 6-month course of antituberculous chemotherapy is recommended although it may not be curative of the uveitis.

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“…However, tuberculosis is now a rare cause of uveitis; the incidence of uveitis in patients with demonstrated tuberculosis is very low and tuberculous uveitis without extraocular involvement is exceptional (28). Chest roentgenography rules out the presence of pulmonary tuberculosis in most cases, and skin testing with purified protein derivative tuberculin if of very limited value without other findings (48). The likelihood of tuberculosis increases in the debilitated patient, the patient with granulomatous AU, and/or the patient whose uveitis does not respond to systemic corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

Patterns of uveitis as a guide in making rheumatologic and immunologic diagnoses

Bañares

Jover

Fernández‐Gutiérrez

et al. 1997

Arthritis & Rheumatism

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Objective. To describe the patterns of clinical presentation in a series of 407 patients with uveitis and to establish the relationship between these patterns and the final diagnosis. Methods. Patients were referred to the Uveitis Clinic of a tertiary hospital from January 1992 to January 1996. All patients received a complete ophthalmologic examination, and a general clinical history was obtained. The current International Uveitis Study Group classification system was used for anatomic classification. To establish the final diagnosis of the most common entities causing uveitis, current diagnostic criteria were used. A discriminant analysis, with diagnostic grouping as the outcome variable and the clinical presentation features as discriminating variables, was performed. Results. With our classification system, 66.5% of the cases could be correctly classified according to the clinical pattern and morphologic findings. By diagnostic groups, discriminant analysis showed that 75% of patients with Behçet's disease, 77.1% of those with spondylarthropathy (including inflammatory bowel disease), 33.3% of those with sarcoidosis, 97.9% of those with toxoplasmosis, 85.7% of those with Vogt‐Koyanagi‐Harada syndrome, 100% of those with herpes, and 50.4% of those with idiopathic uveitis were correctly classified. In the miscellaneous group, which included disease entities with fewer than 5 cases, 42.9% were correctly classified. Conclusion. Rheumatologic evaluation of the patient with uveitis can be more cost‐effective if the referring ophthalmologist follows the classification system described herein, allowing a tailored approach in which only specific and necessary diagnostic tests are used.

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The Utility of Routine Screening of Patients With Uveitis for Systemic Lupus Erythematosus or Tuberculosis

Cited by 75 publications

References 17 publications

The value of an immune response to Mycobacterium tuberculosis in patients with chronic posterior uveitides revisited: utility of the new IGRAs

The value of an immune response to Mycobacterium tuberculosis in patients with chronic posterior uveitides revisited: utility of the new IGRAs

Presumed tuberculous uveitis: diagnosis, management, and outcome

Patterns of uveitis as a guide in making rheumatologic and immunologic diagnoses

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