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Drug-induced Mascerade-uveitis

Horstmann C., Jungmann K., Nölle B.,
Christian-Albrechts-Universität Kiel, Klinik für Ophthalmologie (Kiel)

Objective: A chronic recurrent iridocyclitis of immune suppressed patients throw suspicion on secondary infection. As differential diagnosis should be considered. 
Methods: A case report is about 23 year old patient who received a lung transplantation because of a pulmonary hypertension 5 years before. Therefore a systemic immune suppression consisting of corticosteroide, Cyclosporin A, Azathioprin was given to prevent rejection of the lung. In the following the ophthalmologic case is presented. 
Results: Because of a suspected atypical lung infection with mycoplasma avium the patient was treated with Myambutol and Ethambutol in additions to the systemical immune suppressions. A chronic recurrent Iridocyclitis developed. Because of a dense cellinfiltration of the vitreous the differential diagnosis of an ocular lymphom during immune suppression was taken into account. This hunch ruled out by a diagnostical pars plana vitrectomy. The iridocyclitis could sufficiantly be limited by a treatment with topical corticosteroids. The infection did not stopp until one and a half year later, having stopped the tuberculostatic therapy. 
Conclusions: If you find an uveitits a drug induced Methode - uveitis should be considered. It can occuir even if the ummune system is suppressed by systemical immune suppression.

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