Qd. Nguyen et al., Elevated vitreous concentration of monoclonal immunoglobulin manifesting as schlieren in juvenile rheumatoid arthritis-associated uveitis, ARCH OPHTH, 119(2), 2001, pp. 293-296
We report the clinical findings and analysis of the immunoglobulin (Ig) com
position of the vitreous of a 10-year-old girl with juvenile rheumatoid art
hritis-associated uveitis. The vitreous had a schlieren appearance at the t
ime of pars plana lensectomy and vitrectomy. Analysis of the vitreous fluid
revealed marked elevation of IgG, IgM, IgA, and albumin levels relative to
vitreous fluids from control patients without uveitis. The immunoglobulin
coefficients were also elevated for the IgG and IgM classes of immunoglobul
ins. Immunofixation electrophoresis of the vitreous fluid revealed 2 distin
ct bands of restricted electrophoretic mobility. These studies suggest that
there may be local (intraocular) production of immunoglobulins as an immun
ologic response in ocular inflammatory diseases such as juvenile rheumatoid
arthritis-associated uveitis and that this immunologic response may be mon
oclonal (possibly biclonal or oligoclonal) in nature.