Idiopathic Central Nervous System Inflammatory Disease in the Setting of HLA-B27 Uveitis.

Abstract:

:Purpose: The purpose of the article is to describe a novel case of idiopathic central nervous system inflammatory disease with bilateral human leukocyte antigen (HLA)-B27-positive anterior uveitis. Methods/Results: A 15-year-old African American boy with bilateral HLA-B27-positive anterior uveitis controlled with topical and oral steroids for 8 months acutely developed headaches, left eyelid ptosis, and binocular diplopia. Imaging showed lesions in the right midbrain, superior colliculus, cerebellar peduncles, and cerebellar vermis and leptomeningeal enhancement along the vermian foliae. Cerebral spinal fluid tests showed mild lymphohistiocytic pleocytosis with negative cytology; inflammatory and infectious workup were negative. He received intravenous methylprednisolone without initial symptomatic improvement; repeat magnetic resonance imaging (MRI) showed reduced lesion burden. Oral steroids were continued; his symptoms resolved in 1 month. Repeat MRI 2 months after presentation showed almost complete lesion resolution. Conclusions: Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) was diagnosed. HLA-B27 positivity may represent a novel association with CLIPPERS.

journal_name

Ocul Immunol Inflamm

authors

Crowell EL,Pfeiffer ML,Kamdar AA,Koenig MK,Wittenberg SE,Supsupin EP,Adesina OO

doi

10.1080/09273948.2018.1449865

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

912-917

issue

6

eissn

0927-3948

issn

1744-5078

journal_volume

27

pub_type

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