Uveitis in patients with autoimmune hepatitis.
OBJECTIVE
To report seven cases of uveitis occurring in patients with autoimmune hepatitis (AIH), raising the possibility that uveitis may be an extrahepatic feature of AIH.


METHODS
Multicenter, retrospective, observational case series of patients with AIH and uveitis.


METHODS
One index case was identified at Oregon Health & Science University. Further cases were identified by a web-based survey of members of the American Uveitis Society, the International Uveitis Study Group, the Proctor Foundation mailing list server, and the First SUN International Workshop. Respondents were asked to provide clinical information about uveitis phenotype, AIH features, and treatment.


RESULTS
Clinical information was obtained for seven individuals (four females and three males; age range, seven to 67 years) who suffered from AIH and uveitis. Average duration of follow-up was 5.5 years. All patients had chronic, persistent bilateral uveitis that was anterior (n = 3), intermediate (n = 1), or pan (n = 3) in location. Every patient had complications arising from his or her uveitis, including cataract (n = 5), glaucoma (n = 3), cystoid macular edema (n = 3), and posterior synechiae (n = 3). Final visual acuities ranged from 20/16 to hand movements. To treat the uveitis and/or AIH, the majority of patients required oral prednisone and all seven patients were treated with systemic immunosuppression.


CONCLUSIONS
Despite the small size of this study, our findings suggest an association between AIH and uveitis. The uveitis is chronic, bilateral, and associated with sight-threatening complications, necessitating systemic immunosuppression in some individuals.
Lim
Lyndell L
LL
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA. limllp@unimelb.edu.au
Scarborough
John D
JD
Thorne
Jennifer E
JE
Graham
Elizabeth
E
Kempen
John H
JH
Mackensen
Friederike
F
Nguyen
Quan Dong
QD
Prabriputaloong
Tisha
T
Read
Russell W
RW
Suhler
Eric B
EB
Schwartz
Jonathan M
JM
Smith
Justine R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology; D002648:Child; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D005901:Glaucoma / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008269:Macular Edema / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014792:Visual Acuity
D005938:Glucocorticoids; D007166:Immunosuppressive Agents