Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) – a possible clinical picture of Ocular Borreliosis

Cilj: Prikazati slučaj pacijenta s akutnom posteriornom multifokalnom plakoidnom pigmentnom epiteliopatijom (APMPPE) u sklopu infekcije borelijom Lyme. Prikaz slučaja: Šesnaestogodišnjeg pacijenta uputio je pedijatar zbog naglog pada vidne oštrine na desnom oku. Vidna oštrina kod dolaska bila je 0,01 po Snellenu. Žalio se i na zatiljnu glavobolju unazad nekoliko dana i naveo ubod nepoznatog kukca s okolnim osipom na koži. Na oba oka na fundusu su se utvrdili znakovi korioretinitisa. Učinjena je optička koherentna tomografija (OCT, engl. optical coherence tomography), OCT-angiografija (OCT-A), vidno polje (VP), fluoresceinska angiografija (FA), angiografija indocijanin zelenilom (ICGA, engl. indocyanine green angiography), kompletna laboratorijska, serološka i imunološka obrada, rendgen srca i pluća, magnetska rezonancija (MR) mozga, pregled i konzultacija infektologa i neuropedijatra. Postavljena je dijagnoza APMPPE-a i uvedena peroralna terapija metilprednizolonom 0,5 mg/kg tjelesne težine i doksiciklinom 2 x 100 mg dnevno. Serodijagnostika je pokazala povišene vrijednosti IgM i IgG na Borreliu spp metodom imunoenzimske analize (ELISA, engl. Enzyme Linked Immuno Sorbent Assay), što je bilo potvrđeno western blot analizom. Terapija je dovela do brzog poboljšanja kliničke slike i vidne oštrine na 0,75. Zaključci: Želimo naglasiti da je u slučaju APMPPE-a potrebno napraviti kompletnu obradu kako bi se isključile konkomitantne infekcije, a potrebno je posumnjati i na okularnu boreliozu, osobito u slučaju ugriza krpelja ili nepoznatog kukca, čak i kad se pacijenti ne sjećaju ugriza. Ovakav pristup omogućava promptno liječenje APMPPE-a i borelioze kako bi se smanjile okularne ili/i sistemske komplikacije.

• Publication year

  2019

• Venue

  Medicina Fluminensis

• Publication date

  2019-06-01

• Fields of study

  Not labeled

• Identifiers
  DOI 10.21860/medflum2019_218801
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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