Uveitis Associated with Primary Angiitis of the Central Nervous System

Woolfenden, Andrew R.; Wade, N.K.; Tang, Phua Hwee; Chalmers, Albert J.; Reid, Gregory J.; Teal, Philip

doi:10.1017/s0317167100005837

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Brain imaging is abnormal in the majority of cases of PACNS, although the sensitivity of computed tomography (CT) is only about 30 %. 32 MRI, however, is abnormal in 80-100 % of cases, 14,18,32 and is the brain imaging modality of choice in PACNS. The most common abnormalities are non-specific multifocal hyperintensities in the subcortical white matter on T2-weighted sequences suggestive of leucoaraiosis.…”

Section: Parenchymal Brain Imagingmentioning

confidence: 99%

“…8 Systemic manifestations of vasculitis such as skin rash and arthritis are typically absent in PACNS, and suggest a systemic inflammatory disease with secondary CNS involvement. However, there are occasional reports of PACNS with symptomatic uveitis, [18][19][20] as well as histopathological evidence of sub-clinical involvement of the lungs, heart, kidneys 21 and sural nerve. 22 A tumour-like presentation accounts for 5-15 % of PACNS.…”

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confidence: 99%

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Primary Angiitis of the Central Nervous System - Clinical Approaches, Challenges and Controversies

Gioia¹,

Poppe²,

Lanthier³

2011

European Neurological Review

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Primary angiitis of the central nervous system (PACNS) is a rare and life-threatening form of vasculitis confined to the CNS. A timely diagnosis is a real challenge because clinical manifestations of PACNS are diverse and nonspecific. Headaches, cerebrospinal fluid inflammation and abnormal brain magnetic resonance imaging are prevalent. When PACNS is suspected, a thorough investigation is mandatory to rule out several potential simulators and confirm the diagnosis. Treatment of PACNS is also a challenge involving competing forces, which include the threat of serious adverse effects of potent immunosuppressive agents and the risk of neurological deteriorations due to insufficient immunosuppressant therapy. Efforts are ongoing to delineate subtypes requiring different therapeutic approaches and having distinct prognoses. Despite recent progress, PACNS is still fatal in as much as one-sixth of cases. Long-term follow-up is mandatory in patients with PACNS.

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Section: Parenchymal Brain Imagingmentioning

confidence: 99%

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confidence: 99%

Primary Angiitis of the Central Nervous System - Clinical Approaches, Challenges and Controversies

Gioia¹,

Poppe²,

Lanthier³

2011

European Neurological Review

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“…Woolfenden et al. reported cases of primary angiitis of the central nervous system presenting as acute ischemic stroke following the onset of uveitis ( 16 ). In addition, uveitis is an intraocular inflammatory condition as well as an indicator of systemic inflammation.…”

Section: Introductionmentioning

confidence: 99%

Uveitis increases the risk of stroke among patients with ankylosing spondylitis: A nationwide population-based longitudinal study

Tsung

Huang²,

Chien³

et al. 2022

Front. Immunol.

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Ankylosing spondylitis (AS) is known to increase the risk of stroke. Among patients with AS, uveitis is the most common extra-articular manifestation. However, no previous investigations have discussed the association between uveitis and the risk for developing stroke in patients with AS. This retrospective cohort study aimed to explore the relationship between uveitis and the incidence of stroke in patients with AS by obtaining medical records from January 1, 2000, to December 31, 2015, from the National Health Insurance Research Database, according to the International Classification of Diseases, 9th Revision, Clinical Modification diagnosis codes. The primary outcome was the incidence of stroke. Pearson’s chi-square test and Fisher’s exact test were used to analyze variables. Kaplan–Meier survival curves and univariate and multivariate Cox proportional hazard regression models with and without Fine and Gray’s competing risk model were used to analyze data. Total 828 AS patients with uveitis and 3,312 AS patients without uveitis were identified. During the follow-up period, 137 patients in the uveitis group and 344 in the non-uveitis group developed stroke. Uveitis is a significant risk factor for stroke development in patients with AS (adjusted hazard ratio = 1.846, p < 0.001). Age, diabetes mellitus, hyperlipidemia, hypertension, congestive heart failure, chronic obstructive pulmonary disease, asthma, coronary artery disease, and atrial fibrillation were associated with a higher risk of stroke. After subgroup analysis, both anterior uveitis and posterior segment involvement were found to increase the risk of stroke in patients with AS. Uveitis is associated with an increased risk in both ischemic and hemorrhagic strokes in patients with AS. Therefore, when uveitis is identified, clinicians should pay more attention to the cerebrovascular risk in patients with AS, especially in those with underlying comorbidities.

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Current World Literature

2008

Current Opinion in Rheumatology

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Uveitis Associated with Primary Angiitis of the Central Nervous System

Cited by 4 publications

References 7 publications

Primary Angiitis of the Central Nervous System - Clinical Approaches, Challenges and Controversies

Primary Angiitis of the Central Nervous System - Clinical Approaches, Challenges and Controversies

Uveitis increases the risk of stroke among patients with ankylosing spondylitis: A nationwide population-based longitudinal study

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