A case of multiple sclerosis with granulomatous uveitis in Japan--use of the antilipoarabinomannan (LAM)-B test in differential diagnosis.
OBJECTIVE
To report a patient with multiple sclerosis and associated with granulomatous uveitis, and how anti-lipoarabinomannan (LAM)-B antibody can play a key role in differential diagnosis.


METHODS
Case report.


RESULTS
A 35-year-old Japanese woman with multiple sclerosis, diagnosed 3 years ago, presented with blurred vision in her left eye. Ophthalmological examinations revealed granulomatous iridocyclitis in her left eye and retinal periphlebitis in both eyes. The diagnosis of tuberculosis was suspected because of a positive tuberculin skin test. However, a further examination by an anti-LAM-B antibody test excluded active tuberculosis. Her clinical findings were thought most likely to be caused by multiple sclerosis and treated with corticosteroids.


CONCLUSIONS
We should consider the possibility of multiple sclerosis as the underlying origin in patients with granulomatous uveitis. A measurement of anti-LAM-B antibody titer may be useful in the differential diagnosis of granulomatous uveitis.
Inoue
K
K
Department of Ophthalmology, Branch Hospital, University of Tokyo School of Medicine, Tokyo, Japan. inoue-k@fd5.so-net.ne.jp
Numaga
J
J
Joko
S
S
Izumi
S
S
Kato
S
S
Kawashima
H
H
Fujino
Y
Y
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial / Q000276:immunology*; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids; D006099:Granuloma / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007564:Japan; D008070:Lipopolysaccharides / Q000276:immunology*; D009103:Multiple Sclerosis / Q000150:complications*; D009169:Mycobacterium tuberculosis / Q000276:immunology; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
D000893:Anti-Inflammatory Agents; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D005938:Glucocorticoids; D008070:Lipopolysaccharides; C050016:lipoarabinomannan