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Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis

BACKGROUND: Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). CASE PRESENTATION: We retrospectively reviewe...

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Autores principales: Nakahara, Hisae, Kaburaki, Toshikatsu, Tanaka, Rie, Matsuda, Junko, Takamoto, Mitsuko, Ohtomo, Kazuyoshi, Okinaga, Kimiko, Komae, Keiko, Numaga, Jiro, Fujino, Yujiro, Aihara, Makoto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845152/
https://www.ncbi.nlm.nih.gov/pubmed/29523105
http://dx.doi.org/10.1186/s12886-018-0740-3
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author Nakahara, Hisae
Kaburaki, Toshikatsu
Tanaka, Rie
Matsuda, Junko
Takamoto, Mitsuko
Ohtomo, Kazuyoshi
Okinaga, Kimiko
Komae, Keiko
Numaga, Jiro
Fujino, Yujiro
Aihara, Makoto
author_facet Nakahara, Hisae
Kaburaki, Toshikatsu
Tanaka, Rie
Matsuda, Junko
Takamoto, Mitsuko
Ohtomo, Kazuyoshi
Okinaga, Kimiko
Komae, Keiko
Numaga, Jiro
Fujino, Yujiro
Aihara, Makoto
author_sort Nakahara, Hisae
collection PubMed
description BACKGROUND: Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). CASE PRESENTATION: We retrospectively reviewed the clinical records of five patients who first visited the Uveitis Clinic of the University of Tokyo Hospital between 2009 and 2013, were diagnosed with FU and underwent a vitrectomy for removal of dense vitreous opacity. All were diagnosed as FU by ocular findings and elevation of Goldmann-Witmer coefficient (GWC) value for the rubella virus (RV) antibody. In examinations of the vitreous body, cytological diagnosis, elevation of IL-10/IL-6 ratio, and the kappa/lambda ratio in flow cytometry findings were negative in all cases, whereas monoclonal immunoglobulin heavy chain (IgH) gene rearrangement was positive in 4 cases and negative in 1 case. CONCLUSIONS: Although monoclonal IgH gene rearrangement is thought to be a reliable biomarker for PVRL, a high percentage of vitreous specimens from our FU patients showed pseudo-positive results. Ophthalmologists must take care regarding possible pseudo-positive findings when performing differential diagnosis between FU and PVRL. Combinations of results of cytological diagnosis, IL-10/IL-6 ratio, kappa/lambda ratio, and IgH gene rearrangement may be necessary for a definitive diagnosis of PVRL and differentiation from FU.
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spelling pubmed-58451522018-03-14 Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis Nakahara, Hisae Kaburaki, Toshikatsu Tanaka, Rie Matsuda, Junko Takamoto, Mitsuko Ohtomo, Kazuyoshi Okinaga, Kimiko Komae, Keiko Numaga, Jiro Fujino, Yujiro Aihara, Makoto BMC Ophthalmol Case Report BACKGROUND: Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). CASE PRESENTATION: We retrospectively reviewed the clinical records of five patients who first visited the Uveitis Clinic of the University of Tokyo Hospital between 2009 and 2013, were diagnosed with FU and underwent a vitrectomy for removal of dense vitreous opacity. All were diagnosed as FU by ocular findings and elevation of Goldmann-Witmer coefficient (GWC) value for the rubella virus (RV) antibody. In examinations of the vitreous body, cytological diagnosis, elevation of IL-10/IL-6 ratio, and the kappa/lambda ratio in flow cytometry findings were negative in all cases, whereas monoclonal immunoglobulin heavy chain (IgH) gene rearrangement was positive in 4 cases and negative in 1 case. CONCLUSIONS: Although monoclonal IgH gene rearrangement is thought to be a reliable biomarker for PVRL, a high percentage of vitreous specimens from our FU patients showed pseudo-positive results. Ophthalmologists must take care regarding possible pseudo-positive findings when performing differential diagnosis between FU and PVRL. Combinations of results of cytological diagnosis, IL-10/IL-6 ratio, kappa/lambda ratio, and IgH gene rearrangement may be necessary for a definitive diagnosis of PVRL and differentiation from FU. BioMed Central 2018-03-09 /pmc/articles/PMC5845152/ /pubmed/29523105 http://dx.doi.org/10.1186/s12886-018-0740-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Nakahara, Hisae
Kaburaki, Toshikatsu
Tanaka, Rie
Matsuda, Junko
Takamoto, Mitsuko
Ohtomo, Kazuyoshi
Okinaga, Kimiko
Komae, Keiko
Numaga, Jiro
Fujino, Yujiro
Aihara, Makoto
Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title_full Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title_fullStr Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title_full_unstemmed Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title_short Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
title_sort monoclonal immunoglobulin heavy chain gene rearrangement in fuchs’ uveitis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845152/
https://www.ncbi.nlm.nih.gov/pubmed/29523105
http://dx.doi.org/10.1186/s12886-018-0740-3
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