title: Clinical manifestations of patients with intraocular inflammation and positive QuantiFERON-TB gold in-tube test in a country nonendemic for tuberculosis.
abstract: OBJECTIVE
  To evaluate clinical manifestations of patients with uveitis and scleritis of unknown origin and positive QuantiFERON-TB Gold In-Tube test (quantiferon) in a country not endemic for tuberculosis.
  
  
  METHODS
  Multicenter retrospective cohort study.
  
  
  METHODS
  Retrospective review of the clinical, laboratory, and imaging data of 77 patients. Main outcome measures consisted of ocular and systemic features as well as results of laboratory examinations.
  
  
  RESULTS
  Out of all, 60 of 71 (85%) were living for at least 6 months in tuberculosis-endemic regions. Location of uveitis was variable; posterior uveitis (29/77; 38%) was the most frequent. Two clinical entities were commonly noted: retinal occlusive vasculitis (21/77; 27%) and serpiginoid choroiditis (11/77; 14%). Antituberculosis treatment was completed in 32 patients; 29 of them (91%) achieved complete remission. Mean quantiferon level was 7.5 U/mL; 71% had values above 2 U/mL and 41% above 10 U/mL. We observed no associations between quantiferon levels and clinical and/or imaging features. Previous tuberculosis infection was diagnosed in 5 of 77 patients (6.5%), while hilar/mediastinal lymphadenopathy was found in 25 of 76 patients (33%). Of these, 12 were consistent with the diagnosis of sarcoidosis, 9 were typical for (prior) tuberculosis, and 4 were compatible with both diagnoses.
  
  
  CONCLUSIONS
  Ocular features of patients with idiopathic uveitis and positive quantiferon were diverse, but retinal occlusive vasculitis and serpiginoid choroiditis were common. The quantiferon levels were usually highly elevated and 33% of patients exhibited lymphadenopathy, suggesting frequently the diagnosis of sarcoidosis. Ocular inflammation reacted favorably to antituberculosis treatment, although only a small minority had documented (prior) tuberculosis.
authors.affiliation: Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, University of Indonesia & Cipto Mangunkusumo Hospital Kirana, Jakarta, Indonesia.
authors.forename: Rina
authors.initials: R
authors.lastname: La Distia Nora
authors.affiliation: Rotterdam Eye Hospital, Rotterdam, Netherlands.
authors.forename: Mirjam E J
authors.initials: ME
authors.lastname: van Velthoven
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Ninette H
authors.initials: NH
authors.lastname: Ten Dam-van Loon
authors.affiliation: Rotterdam Eye Hospital, Rotterdam, Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Misotten
authors.affiliation: Department of Pulmonary Diseases, Erasmus Medical Center, Rotterdam, Netherlands.
authors.forename: Marleen
authors.initials: M
authors.lastname: Bakker
authors.affiliation: Department of Clinical Immunology, Erasmus Medical Center, Rotterdam, Netherlands.
authors.forename: Martin P
authors.initials: MP
authors.lastname: van Hagen
authors.affiliation: Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands; Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: a.rothova@erasmusmc.nl.
authors.forename: Aniki
authors.initials: A
authors.lastname: Rothova
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002833:Choroiditis / Q000175:diagnosis*; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D031300:Retinal Vasculitis / Q000175:diagnosis*; D012189:Retrospective Studies; D015423:Scleritis / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D014605:Uveitis / Q000175:diagnosis*; D014792:Visual Acuity
chemical_list: D000995:Antitubercular Agents