OCULAR TUBERCULOSIS IN SYSTEMIC LUPUS-ERY THEMATOSUS AND IMMUNOSUPPRESSIVE THERAPY

Background A marked reduction in eye disease attributed to tuberculosi s has occurred over the past several decades. In recent years, however , tuberculosis has reemerged as a serious public health problem. We re port a case of a severe ocular tuberculosis in a patient with systemic lupus erythematosus and immunosuppressive therapy. Patient The 36-yea rs-old woman underwent an immunosuppressive therapy because of a syste mic lupus erythematosus detected two years earlier. After holidays on the Philippines Mycobacterium tuberculosis was found in a bronchial la vage. Two months later fundoscopy showed severe subretinal exsudation with overlying serous retinal detachment. Within several months these findings progressed to a panuveitis with spontaneous perforation. Hist opathologically a granulomatous panophthalmitis could be found with gi ant cells. Two months later acid-fast bacilli were detected in orbital lesions. Conclusion In immunosuppressed patients there is still an in creased risk for severe ocular tuberculosis. Therefore it is important to think of this almost forgotten disease in those cases.