Abstract
Resumo Relatar um caso de paciente com Retinopatia vaso-oclusiva por Lupus Eritematoso Sistemico (LES) associado a Sindrome do Anticorpo Antifosfolipideo (SAF), que se iniciou com um quadro de anemia hemolitica autoimune acompanhado por baixa visual subita monocular. Poucos casos foram descritos na literatura nacional e mundial em que o LES se manifeste primeiramente com alteracoes oculares. O screening dos Anticorpos antifosfolipideos (APAs) e de suma importância para pacientes com retinopatia lupica para que seja instituida a terapia imediata com anticoagulantes como forma de prevenir a trombose vascular, o que piora o prognostico visual.
Highlights
Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystemic disease which may affect any part of the human body, including the eye
The Antiphospholipid Antibody Syndrome (AAS) is an autoimmune disease defined by the presence of antiphospholipid antibodies (APA) along with a clinical manifestation of the disease: arterial/venous thromboses and recurrent fetal loss.[2]. Despite the recurrent condition of arterial and/or venous thrombosis,other findings may be seen, such as: false VDRL and thrombocytopenia.[3]. APA affect the segments of the blood vases over the body and may lead to hypercoagulability.[4]. Ocular affection is most frequently manifested with the occurrence of retinal thrombosis, mainly among the youngsters.[5]
AAS occurs in 34% 42% of SLE patients.[6]. Retinal vascular occurrence will depend on the patient having or not APA associated to SLE.[6]. As an example, retinal vascular occlusion is more frequent in APA patients (13.9%) than in those without APA (0.9%)
Summary
Systemic Lupus Erythematosus (SLE) is an autoimmune, multisystemic disease which may affect any part of the human body, including the eye. The Antiphospholipid Antibody Syndrome (AAS) is an autoimmune disease defined by the presence of antiphospholipid antibodies (APA) along with a clinical manifestation of the disease: arterial/venous thromboses and recurrent fetal loss.[2] Despite the recurrent condition of arterial and/or venous thrombosis,other findings may be seen, such as: false VDRL and thrombocytopenia.[3] APA affect the segments of the blood vases over the body and may lead to hypercoagulability.[4] Ocular affection is most frequently manifested with the occurrence of retinal thrombosis, mainly among the youngsters.[5]. The objective of the present study is to report the case of a patient with vaso-oclusive retinopathy by SLE associated to AAS with the first manifestation being sudden low vision of the left eye associated to symptoms characteristic of autoimmune hemolytic anemia. We requested colored (Figure 1) and fluorescent (Figure 2) retinography, OCT (OpticalCoherenceTomography) of the macula (Figure 3) as soon as she came to the service
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