Hypertensive choroidopathy in atypical hemolytic-uremic syndrome.
Details
Serval ID
serval:BIB_B2AAC1DA6C81
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Hypertensive choroidopathy in atypical hemolytic-uremic syndrome.
Journal
European journal of ophthalmology
ISSN
1724-6016 (Electronic)
ISSN-L
1120-6721
Publication state
Published
Issued date
03/2021
Peer-reviewed
Oui
Volume
31
Number
2
Pages
NP63-NP66
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
We present the case of a 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome with a hypertensive crisis, who presented a bilateral serous retinal detachment.
A 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome, was referred for blurred vision in both eyes, evolving over 7 days. Treatment including hemodialysis, plasma exchange, systemic steroids, antihypertensive medications and eculizumab was started 1 month prior to referral. At presentation, best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye. Retinal examination revealed bilateral serous retinal detachment in the posterior pole and some small, flat, variably pigmented lesions. Optical coherence tomography confirmed marked serous retinal detachment in both eyes. Fluorescein and indocyanine green angiography was performed. Treatment for systemic hypertension was changed. Seven days later, dilated fundus examination and optical coherence tomography demonstrated a significant regression of the serous retinal detachment. Her visual acuity improves in both eyes at the last control, showing at fundus examination a complete resolution of the exudative detachment but a persistence of variable flat pigmented lesion.
Although multiple organ systems are commonly affected in hemolytic uremic syndrome, ocular involvement has only been described in very few cases. Ocular manifestations in atypical hemolytic uremic syndrome include retinal, choroidal and vitreal hemorrhages, retina and/or ischemic signs. Bilateral serous retinal detachment may also be a sign of atypical hemolytic uremic syndrome or even the first manifestation of a hypertensive event.
A 22-year-old woman, diagnosed as having atypical hemolytic uremic syndrome, was referred for blurred vision in both eyes, evolving over 7 days. Treatment including hemodialysis, plasma exchange, systemic steroids, antihypertensive medications and eculizumab was started 1 month prior to referral. At presentation, best-corrected visual acuity was 20/40 in the right eye and 20/25 in the left eye. Retinal examination revealed bilateral serous retinal detachment in the posterior pole and some small, flat, variably pigmented lesions. Optical coherence tomography confirmed marked serous retinal detachment in both eyes. Fluorescein and indocyanine green angiography was performed. Treatment for systemic hypertension was changed. Seven days later, dilated fundus examination and optical coherence tomography demonstrated a significant regression of the serous retinal detachment. Her visual acuity improves in both eyes at the last control, showing at fundus examination a complete resolution of the exudative detachment but a persistence of variable flat pigmented lesion.
Although multiple organ systems are commonly affected in hemolytic uremic syndrome, ocular involvement has only been described in very few cases. Ocular manifestations in atypical hemolytic uremic syndrome include retinal, choroidal and vitreal hemorrhages, retina and/or ischemic signs. Bilateral serous retinal detachment may also be a sign of atypical hemolytic uremic syndrome or even the first manifestation of a hypertensive event.
Keywords
Antibodies, Monoclonal, Humanized/therapeutic use, Atypical Hemolytic Uremic Syndrome/complications, Atypical Hemolytic Uremic Syndrome/diagnosis, Atypical Hemolytic Uremic Syndrome/drug therapy, Choroid Diseases/diagnosis, Choroid Diseases/drug therapy, Choroid Diseases/etiology, Coloring Agents/administration & dosage, Complement Inactivating Agents/therapeutic use, Female, Fluorescein Angiography, Glucocorticoids/therapeutic use, Humans, Hypertension/diagnosis, Hypertension/drug therapy, Hypertension/etiology, Indocyanine Green/administration & dosage, Plasma Exchange, Renal Dialysis, Retinal Detachment/diagnostic imaging, Retinal Detachment/etiology, Tomography, Optical Coherence, Visual Acuity/physiology, Young Adult, Elschnig spots, Hypertensive choroidopathy, atypical hemolytic uremic syndrome, serous retinal detachment
Pubmed
Web of science
Create date
12/03/2021 19:53
Last modification date
27/02/2023 16:13