title: Very severe HLA B27-associated panuveitis mimicking endophthalmitis: a case series.
abstract: OBJECTIVE
  To report rare but important instances of very severe, hyperacute HLA B27-associated panuveitis, mimicking infective endophthalmitis and providing challenges to both diagnosis and management.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  Four patient records were reviewed. Demographic features, clinical findings, course of uveitis, diagnostic/therapeutic measures, and outcomes are reported.
  
  
  RESULTS
  All cases presented with severe panuveitis with visual acuities below 6/60 and poor fundal views. Three patients underwent intraocular fluid sampling for microbiology. All required systemic high-dose corticosteroid treatment, and two also needed oral immunosuppression. All eventually required cataract extraction. Final visual acuity varied from 6/12 to 6/6.
  
  
  CONCLUSIONS
  HLA B27-associated uveitis may be unusually severe and may cause a panuveitis, mimicking infective endophthalmitis. The course may be prolonged and difficult with frequent complications including cataract.
authors.affiliation: Manchester Royal Eye Hospital, Manchester, UK. casanghvi1@googlemail.com
authors.forename: Chintan
authors.initials: C
authors.lastname: Sanghvi
authors.forename: Karl
authors.initials: K
authors.lastname: Mercieca
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002387:Cataract Extraction; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000175:diagnosis*; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D008297:Male; D015864:Panuveitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D015796:HLA-B27 Antigen; D007166:Immunosuppressive Agents