Interpreting vasculitis-enterogenic malabsorption syndrome

Enterogenic malabsorption syndrome is a multisystem disease caused by Corynebacterium whipplei and characterized by malabsorption, diarrhea, and polyarthritis. The microorganisms can be detected in vitreous specimens from patients with uveitis and retinal vasculitis by polymerase chain reaction and electron microscopy. Few cases have been reported with characteristic features consistent with other retinal vasculitides, such as hemorrhages, exudates, and retinal capillary blockage. Viruses associated with vasculitis include hepatitis B virus. This virus has been reported to be associated with optic nerve papillitis as well as vasculitis of the central nervous system. Retinal vasculitis in combination with primary eye disease Retinal vasculitis can be seen in a number of diseases that are limited to the eye. Birdshot chorioretinal chorioretinopathy is a disease associated with HLA-A29 and is characterized by deep circular cream-like damage in the posterior pole of the retina bilaterally. The anterior chamber is often free of abnormalities, although vitreous cells, vasculitis, and cystoid macular edema may be present. Fluorescence staining angiography reveals the more prominent retinal vasculopathy in this disease, however, the creamy lesions seen on fundoscopy are more pronounced. Some scholars have reported birdshot shotgun typical lesions after many years in patients with idiopathic chronic retinal vasculitis associated with HLA-A29. Horizontal vitritis is a type of uveitis that is characterized by a horizontal aspect. “Snowdrift” deposits or cellular deposits appear beneath the vitreous. Often, patients present with perivasculitis or phlebitis with or without cystoid macular edema. Although vision loss in these patients is often caused by cystoid macular edema, it can sometimes be caused by snowdrift neovascularization, both of which require aggressive anti-inflammatory treatment. Because uveitis is often combined with systemic diseases such as multiple sclerosis, tuberculosis, and infections, a thorough and complete workup is needed in these patients.