Blau syndrome with persistent fetal vasculature: a case report.


Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
30 Jun 2023
Historique:
received: 18 01 2023
accepted: 13 05 2023
medline: 3 7 2023
pubmed: 30 6 2023
entrez: 29 6 2023
Statut: epublish

Résumé

Blau Syndrome (BS) is a rare autosomal dominant noncaseous granulomatous disease caused by mutations in the NOD2 gene. The disease is characterized by granulomatous dermatitis, symmetrical arthritis, and uveitis, which, if left untreated, can progress to blindness. The diagnosis of BS can be challenging because of its rarity and overlap with other rheumatologic disorders. Early detection of ocular involvement is critical to prevent vision loss and improve the prognosis of patients with BS. In this report, we present a case of a five-year-old Chinese girl diagnosed with BS one year ago after presenting with a systemic rash and urinary calculi. Genetic testing was recommended by a physician, and a heterozygous mutation of the NOD2 gene c.1538T > C (p.M513T) was identified. Eight months ago, due to bilateral corneal punctate opacity, we had examined and diagnosed bilateral uveitis, bilateral corneal zonal degeneration, persistent fetal vasculature (PFV) in the right eye, and perivascular granuloma in the right eye. As a result, Vitrectomy was performed on the right eye, resulting in a significant improvement in visual acuity from 1/50 on the first day after surgery to 3/10 after 1 week. After 6 months, the visual acuity of the right eye was maintained at 3/20, but opacification of the lens posterior capsule was observed. Follow-up appointments are ongoing to monitor the condition of the affected eyes. Our report underscores the importance of prompt detection and management of ocular involvement in BS accompany with PFV to prevent vision loss and improve patient outcomes. This report details the case of a child diagnosed with BS who accompanied a periretinal granuloma and PFV in the right eye. Regrettably, the left eye was observed to have no light perception (NLP) with the fundus not being visible. The occurrence of ocular complications in patients with BS, must be closely monitored to prevent vision loss and enhance treatment outcomes. This case underscores the importance of prompt diagnosis and management of ocular complications in patients with BS to prevent further damage and optimize patient outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Blau Syndrome (BS) is a rare autosomal dominant noncaseous granulomatous disease caused by mutations in the NOD2 gene. The disease is characterized by granulomatous dermatitis, symmetrical arthritis, and uveitis, which, if left untreated, can progress to blindness. The diagnosis of BS can be challenging because of its rarity and overlap with other rheumatologic disorders. Early detection of ocular involvement is critical to prevent vision loss and improve the prognosis of patients with BS.
CASE PRESENTATION METHODS
In this report, we present a case of a five-year-old Chinese girl diagnosed with BS one year ago after presenting with a systemic rash and urinary calculi. Genetic testing was recommended by a physician, and a heterozygous mutation of the NOD2 gene c.1538T > C (p.M513T) was identified. Eight months ago, due to bilateral corneal punctate opacity, we had examined and diagnosed bilateral uveitis, bilateral corneal zonal degeneration, persistent fetal vasculature (PFV) in the right eye, and perivascular granuloma in the right eye. As a result, Vitrectomy was performed on the right eye, resulting in a significant improvement in visual acuity from 1/50 on the first day after surgery to 3/10 after 1 week. After 6 months, the visual acuity of the right eye was maintained at 3/20, but opacification of the lens posterior capsule was observed. Follow-up appointments are ongoing to monitor the condition of the affected eyes. Our report underscores the importance of prompt detection and management of ocular involvement in BS accompany with PFV to prevent vision loss and improve patient outcomes.
CONCLUSIONS CONCLUSIONS
This report details the case of a child diagnosed with BS who accompanied a periretinal granuloma and PFV in the right eye. Regrettably, the left eye was observed to have no light perception (NLP) with the fundus not being visible. The occurrence of ocular complications in patients with BS, must be closely monitored to prevent vision loss and enhance treatment outcomes. This case underscores the importance of prompt diagnosis and management of ocular complications in patients with BS to prevent further damage and optimize patient outcomes.

Identifiants

pubmed: 37386644
doi: 10.1186/s13256-023-03983-1
pii: 10.1186/s13256-023-03983-1
pmc: PMC10311772
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

301

Informations de copyright

© 2023. The Author(s).

Références

Retina. 2009 Nov-Dec;29(10):1545-6
pubmed: 19898191
Arch Rheumatol. 2019 Nov 06;35(1):117-127
pubmed: 32637927
Pediatr Nephrol. 2010 May;25(5):977-81
pubmed: 20084402
Ophthalmic Genet. 2021 Dec;42(6):753-764
pubmed: 34251956
Semin Ophthalmol. 2013 Sep-Nov;28(5-6):327-32
pubmed: 24010719
Autoimmun Rev. 2012 Nov;12(1):44-51
pubmed: 22884558
Curr Opin Rheumatol. 2011 Sep;23(5):411-8
pubmed: 21788900
Acta Ophthalmol. 2015 May;93(3):253-7
pubmed: 25209167
Retin Cases Brief Rep. 2018 Fall;12 Suppl 1:S29-S32
pubmed: 29210964
J Rheumatol. 2007 Dec;34(12):2504-5
pubmed: 18061972
Arthritis Rheum. 2010 Jan;62(1):250-7
pubmed: 20039400
Arch Ophthalmol. 1976 Jun;94(6):945-50
pubmed: 938285
J Pediatr. 1985 Nov;107(5):689-93
pubmed: 4056967
Front Med (Lausanne). 2021 Aug 13;8:690594
pubmed: 34485332

Auteurs

Miao Liu (M)

School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Yong Zeng (Y)

Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.

Jie Zhong (J)

Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. zhongjie@med.uestc.edu.cn.

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