A case of multiple sclerosis with granulomatous uveitis in Japan - Use of the antilipoarabinomannan (LAM)-B test in differential diagnosis

PURPOSE: To report a patient with multiple sclerosis and associated with gr anulomatous uveitis, and how anti-lipoarabinomannan (LAM)-B antibody can pl ay a key role in differential diagnosis. METHODS: Case report. RESULTS: A 35-year-old Japanese woman with multiple sclerosis, diagnosed 3 years ago, presented with blurred vision in her left eye. Ophthalmological examinations revealed granulomatous iridocyclitis in her left eye and retin al periphlebitis in both eyes. The diagnosis of tuberculosis was suspected because of a positive tuberculin skin test. However, a further examination by an anti-LAM-B antibody test excluded active tuberculosis. Her clinical f indings were thought most likely to be caused by multiple sclerosis and tre ated with corticosteroids. CONCLUSION: We should consider the possibility of multiple sclerosis as the underlying origin in patients with granulomatous uveitis. A measurement of anti-LAM-B antibody titer may be useful in the differential diagnosis of g ranulomatous uveitis. (Am J Ophthalmol 2001;131:524-526. (C) 2001 by Elsevi er Science Inc. All rights reserved).