Abstract: A 21-year-old man experienced unilateral vision loss associated with multiple atrophic chorioretinal lesions. He was treated for a presumptive diagnosis of acute retinal necrosis, but his vision did not improve with antiviral therapy. Over the course of several weeks, his symptoms progressed to involve both eyes. The fellow eye showed characteristic yellow-white placoid lesions, prompting treatment with oral corticosteroids for acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Despite high-dose therapy with prednisone 80 mg daily, the patient developed the acute onset of mental status changes within the next several days. Neuroimaging revealed multifocal large-vessel strokes associated with cerebral edema; these infarcts led to herniation and death. Postmortem histopathologic examination confirmed granulomatous inflammation in both ocular and cerebral vasculatures. Together with findings from multimodal imaging obtained throughout this patient's clinical course, our findings support the notion that granulomatous choroiditis is the mechanism of the ocular lesions seen in APMPPE. This granulomatous inflammation can also affect cerebral vessels, leading to strokes. Address correspondence to Gregory P. Van Stavern, MD, Washington University in St. Louis, St. Louis, MO; E-mail: vanstaverng@wustl.edu The authors report no conflicts of interest. R. N. Maamari and L. Stunkel contributed equally to this work. © 2019 by North American Neuro-Ophthalmology Society
http://bit.ly/2CKTnee
Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com
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- A Brief History of Circannual Time
- Surgical site infections after parotidectomy: mana...
- Oculorespiratory Reflex During Repair of an Orbita...
- Association of Chronic Rhinosinusitis With Depress...
- The Centers for Medicare & Medicaid Services' Over...
- Does Chronic Rhinosinusitis Lead to Psychiatric Di...
- Gezielte Exposition versus Allergenmeidung
- Schlechte Bewertungen im Internet: dulden oder lös...
- Allergologie unter Druck
- So sicher ist die intranasale Glukokortikoidtherapie
- Weitergabe von Daten und Datenübertragung — nur mi...
- Defizite in der Anaphylaxietherapie
- Lesenswerte Therapiebegleitung für Tumorpatienten
- Akupunktur bei allergischen Erkrankungen — wann is...
- Skin, Body Dysmorphic Disorder, and Other Syndromes
- Is the Current Classification of Urethritis as Gon...
- Psoriasis and Depression: The Role of Inflammation
- Medical Malpractice Issues in Dermatology: Clinica...
- Screening for Body Dysmorphic Disorders in Acne Pa...
- The Super Shaving Technique to Correct the Trapdoo...
- Haemophilus Species Isolated in Urethral Exudates ...
- Granulomatous Reaction in a Patient With Metastati...
- Erythematous Papules on the Dorsum of the Hand
- Recurrent Facial Edema
- Scratch-Induced Lesions…Without the Scratching
- Granulocyte Colony-Stimulating Factor (G-Csf)–Prod...
- Advanced-Stage Thymoma Associating Multiple Parane...
- Dermatomyositis-like Eruption in a Woman Treated W...
- Big Data Research in Neuro-Ophthalmology: Promises...
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- Neuro-Ophthalmology in Canada
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- A Tough NUT to Crack: A 47-Year-Old With Diplopia ...
- Peripapillary Vessel Density Measured by Optical C...
- Minocycline-Induced Vasculitis Presenting as a Thi...
- Monocular Single Saccadic Pulses
- Do Most Patients With a Spontaneous Cerebrospinal ...
- Black and Brown Oro-facial Mucocutaneous Neoplasms
- Adamantinoma-Like Ewing Sarcoma of the Thyroid: A ...
- A Guide to Yellow Oral Mucosal Entities: Etiology ...
- Ulcerated Lesions of the Oral Mucosa: Clinical and...
- Erythematous and Vascular Oral Mucosal Lesions: A ...
- Non-HPV Papillary Lesions of the Oral Mucosa: Clin...
- A Rainbow of Colors and Spectrum of Textures: An A...
- Candidiasis: Red and White Manifestations in the O...
- Lumps and Bumps of the Gingiva: A Pathological Mis...
- HPV-Related Papillary Lesions of the Oral Mucosa: ...
- Tongue Lumps and Bumps: Histopathological Dilemmas...
- Frictional Keratosis, Contact Keratosis and Smokel...
- Lichenoid Characteristics in Premalignant Verrucou...
- Black and Brown: Non-neoplastic Pigmentation of th...
- Development and Characterization of a Novel Monocl...
- Epitope Mapping of Antidiacylglycerol Kinase α Mon...
- The Diagnostic Tests for Detection of Helicobacter...
- Respiratory Syncytial Virus
- Penalized Supervised Star Plots: Example Applicati...
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- Unrecognized Pseudohypoparathyroidism Type 1A as a...
- Diabetic Ketoacidosis Revealing a Severe Hypertrig...
- Randomized, Controlled, Multicentered, Double-Blin...
- Treatment of Facial Telangiectases With Glycerin S...
- Efficacy of Microneedling and Photodynamic Therapy...
- The Frequency of Auricular Cartilage Invasion by N...
- How We Do It: Use of Reinforced Adhesive Skin Clos...
- Cellular Dermatofibroma: Clinicopathologic Review ...
- Suture Treatment for Pincer Nail Deformity: An Ine...
- Use of Insulin Syringes for Precision Filler in Pe...
- A Diagnostic Challenge: Changes in Histopathologic...
- Assessment of Skin Physiology Change and Safety Af...
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- Cutaneous Metastasis of Malignant Peripheral Nerve...
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- Repair of a Large Dorsal Hand Defect After Mohs Mi...
- Institution of a Double-Dosing Protocol Using Cyan...
- Satellite and In-Transit Metastatic Disease in Mel...
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- Cutaneous Sarcomatoid Squamous Cell Carcinoma of t...
- Cerebrovascular pathology in cerebral amyloid angi...
- Role of epithelial–mesenchymal transition factors ...
- Acknowledgement to reviewers 2018
- Comprehensive analysis of PD-L1 expression, HER2 a...
- Compact buds with biphasic differentiation and cal...
- A mismatch repair-deficient and HPV-negative anore...
- National multicentric evaluation of quality of pat...
- European follow-up of incorrect biomarker results ...
- Analysis of the prognostic relevance of sex-steroi...
- Acute Epstein–Barr virus-positive cytotoxic T cell...
- Targeted sequencing with a customized panel to ass...
- In this issue
- Validation of the pathological prognostic staging ...
- Evaluation of tumor-infiltrating lymphocytes in os...
- The impact of exercise on asthma
- Use of population data for assessing trends in wor...
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