[Ocular tuberculosis in systemic lupus erythematosus and immunosuppressive therapy].
BACKGROUND
A marked reduction in eye disease attributed to tuberculosis has occurred over the past several decades. In recent years, however, tuberculosis has reemerged as a serious public health problem. We report a case of a severe ocular tuberculosis in a patient with systemic lupus erythematosus and immunosuppressive therapy.


METHODS
The 36-years-old woman underwent an immunosuppressive therapy because of a systemic lupus erythematosus detected two years earlier. After holidays on the Philippines Mycobacterium tuberculosis was found in a bronchial lavage. Two months later fundoscopy showed severe subretinal exsudation with overlying serous retinal detachment. Within several months these findings progressed to a panuveitis with spontaneous perforation. Histopathologically a granulomatous panophthalmitis could be found with giant cells. Two months later acid-fast bacilli were detected in orbital lesions.


CONCLUSIONS
In immunosuppressed patients there is still an increased risk for severe ocular tuberculosis. Therefore it is important to think of this almost forgotten disease in those cases.
Anders
N
N
Augenklinik im Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Wollensak
G
G
D000328:Adult; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005123:Eye / Q000473:pathology; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D009336:Necrosis; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010202:Panophthalmitis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone