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Generalized polyangiitis may pose as atypical conjunctivitis
SAN FRANCISCO — Generalized polyangiitis can mask itself as atypical conjunctivitis, and high clinical suspicion for vasculitis should warrant immediate additional evaluation and tissue biopsy, according to a physician here.
"Critical review of radiologic images and tissue biopsies can aid in the accurate diagnosis of this systemic disease because missing the diagnosis can be a fatal mistake," Evan C. Pike, MD, said at the American Society of Cataract and Refractive Surgery meeting.
Evan C. Pike
A case study of a 19-year-old man with persistent conjunctivitis in both eyes appeared indicative of allergic keratoconjunctivitis. Symptoms advanced with fatigue, myalgia, cough, chronic nasal congestion and sinusitis symptoms, and lab tests and renal biopsy confirmed the diagnosis of generalized polyangiitis.
"Tissue is the issue in this situation," Pike said.
It is important to make a diagnosis of generalized polyangiitis because if left untreated, the survival rate is approximately 5 months, with 18% of patients surviving at 1 year, he said.
After diagnosis and treatment with cyclophosphamide and prednisolone, there is a 93% remission rate.
"Re-review your ancillary testing. I think that’s what we can do to more focus our approaches, especially on something like vasculitis that carries such a significant morbidity and mortality," Pike said.
Disclosure: Pike has no relevant financial disclosures.