The subject is a female 41 years, she has complained on swollen and pain in both eyes since 1 moth ago. this pain has started when she went swimming in her private pool. the ophthalmologist prescribed a few antibiotics and asked her to do ANA,ACE,HLAB5,51 and 27.
she has already ITP.she went to the lab before starting antibiotic therapy. Her laboratory results are HLAB 5 and 51 positive.ANA is 0.8,ACE is 40 (6-54) and HLA b27 negative. Can we suspect to behcet disease,if yes what is the confirmation tests?if no what would you think about she?
Her eyes pain and inflammation in her eyes were improved after starting antibiotics.
1. A report from the ophtalmologist is mandatory. We are not given here what he said. Other MDs are not qualified to diagnose eye problems, even rheumatologists who are responsible for the treatment of arthritis-related eye problems.
2. The description fits conjunctivitis. Behcet presents differently: uveitis of anterior and/or posterior chambers. There are criteria for Behcet, and this patient does not fulfill them, at least with the data provided, which is insufficient.
3. HLA typing is never used to diagnose rheumatic conditions (in joints or eyes or...). Even if the patient is HLA B5 positive, no diagnosis must be derived from this.
HLA Typing for rheumatic diseases is useful in cohort and epidemiological studies.
4. The data presented is not sufficient for a diagnosis. But the description of the condition seems to direct to conjunctivitis, to be treated by an ophtalmologist
In Behcet disease typical (92-100%) for patients is recurrent (3 or more times) painful apthosis. More over as far as the eyes are concern more frequently uveitis or retinal vasculitis is present. According to the guidelines, for a patient to be diagnosed with Behcet's disease, the patient must have oral ulcers along with 2 out of the following 4 symptoms: genital ulcers, skin lesions, eye inflammation, pathergy reaction.
More information:
http://www.uveitissociety.org/pages/diseases/behcets.pdf
http://www.mersi.us/Behcets.pdf
Interestingly Patients in settings where the use of unspecified drugs prior to reporting at the clinic is not an uncommon occurrence, the specifics hardly hold. They could present without mouth ulcers, though. Is some careful elucidation of the use of steroids not a vital probe in this vein?
1. A report from the ophtalmologist is mandatory. We are not given here what he said. Other MDs are not qualified to diagnose eye problems, even rheumatologists who are responsible for the treatment of arthritis-related eye problems.
2. The description fits conjunctivitis. Behcet presents differently: uveitis of anterior and/or posterior chambers. There are criteria for Behcet, and this patient does not fulfill them, at least with the data provided, which is insufficient.
3. HLA typing is never used to diagnose rheumatic conditions (in joints or eyes or...). Even if the patient is HLA B5 positive, no diagnosis must be derived from this.
HLA Typing for rheumatic diseases is useful in cohort and epidemiological studies.
4. The data presented is not sufficient for a diagnosis. But the description of the condition seems to direct to conjunctivitis, to be treated by an ophtalmologist
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