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June 1990

Ocular Manifestations of Patients With Circulating Antineutrophil Cytoplasmic Antibodies

Author Affiliations

From the Departments of Ophthalmology (Drs Pulido, Nerad, Sobol, and Folberg) and Pathology (Drs Goeken and Folberg), The University of Iowa Hospitals and Clinics, Iowa City.

Arch Ophthalmol. 1990;108(6):845-850. doi:10.1001/archopht.1990.01070080087041

• Antineutrophil cytoplasmic antibodies are seen in patients with systemic vasculitides, especially Wegener's granulomatosis. Antineutrophil cytoplasmic antibodies are helpful laboratory markers for these diseases. We report on the ocular findings of six patients with systemic vasculitis who had antineutrophil cytoplasmic antibodies. Four patients had systemic Wegener's granulomatosis, one had microscopic polyarteritis, and in one a specific histopathologic diagnosis could not be made. Two patients were first evaluated for systemic vasculitis because of their ocular manifestations. Ocular findings included ptosis, bilateral lacrimal gland masses, proptosis, choroidal folds, episcleritis, phlebitis, retinal and vitreous hemorrhage, keratitis sicca, and bilateral central scotomas. It was difficult to make a systemic diagnosis in all cases. If systemic vasculitis is in the differential diagnosis of a patient with suggestive ocular findings, antineutrophil cytoplasmic antibody testing should be considered. A prospective study of antineutrophil cytoplasmic antibody testing should be considered in patients with ocular findings that suggest the possibility of vasculitis.

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