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anterior_uveitis_ddx [2016/01/27 02:30] – created Scott Larsonanterior_uveitis_ddx [2025/04/18 20:40] (current) – external edit 127.0.0.1
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-====== Anterior Uveitis Causes ======+====== Pediatric Anterior Uveitis ======
  
-  * Behçet syndrome +==== Causes ==== 
-  * Fuchs heterochromic iridocyclitis +  * Primarily Ocular  
-  * Glaucomacyclitic crisis (Posner Schlossman) +    * Infectious 
-  * Herpetic iritis +      * post-surgical (P. Acnes) 
-  * Idiopathic +      * herpes viruses 
-  IOL- related iritis +    * Post-traumatic iritis 
-  JRA-related iridocyclitis +    * Fuchs heterochromic iridocyclitis 
-  * Kawasaki syndrome +    * Lens-related 
-  Lens related Uveitis +      * IOL related 
-  * Low-grade infectious endophthalmitis (P. acnes+      * Glaucomacyclitic crisis (Posner Schlossman) 
-  Sarcoidosis +  * Systemic Non-infectious Disease 
-  Seronegative spondyloarthropathies +    [[jia_screening|Juvenile Idiopathic Arthritis]] 
-  Syphilis +    [[behcets|Behçet syndrome]] 
-  Traumatic iritis+    [[tubulointerstitial_nephritis_uveitis|Tubulointerstitial Nephritis and Uveitis (TINU)]] 
 +    * Sarcoidosis 
 +    * Kawasaki syndrome 
 +    Juvenile onset spondyloarthropathies (HLA-B27 associated) 
 +      * Juvenile Ankylosing spondilitis 
 +      * Reactive arthritis 
 +      * Inflammatory Bowel disease related  
 +      * Psoriatic arthritis  
 +  * Systemic Infectious Diseases 
 +    * Post Infectious Autoimmune uveitis (streptococcal pharyngitis
 +    Herpes Viruses (VZV, HSV) 
 +    Syphilis 
 +    Tuberculosis 
 +    Lyme
  
-{{tag>ddx}}+==== Work-up for cases without an obvious cause ==== 
 +  * Consider working up for:  
 +    * Sarcoidosis 
 +      * **angiotensin-converting enzyme (ACE)** and serum lysozyme levels 
 +      * followed by chest x-ray 
 +      * followed by Chest CT 
 +    * Syphilis 
 +      * Non-treponemal testing 
 +        * **RPR** -or- 
 +        * VDRL 
 +      * Followed by treponemal testing 
 +        * fluorescent treponemal antibody absorption (FTA-ABS) -or- 
 +        * Treponema pallidum particle agglutination (TPPA) 
 +    * Tuberculosis 
 +      * **Serum QuantiFERON Gold** or PPD 
 +    * Herpes viruses 
 +      * **HSV PCR** 
 +      * VZV PCR 
 +    * JIA without significant arthritis- **ANA** 
 +    * TINU 
 +      * **urinary β2 microglobulin** 
 +      * **BUN, Creatinine** 
 +      * **urinalysis** (looking for proteinuria, normoglycemic glycosuria, microheaturia, sterile pyuria) 
 +    * Lyme titers in endemic areas or travel to endemic areas 
 +      * **Lyme DNA PCR**  or Lyme Disease AB Western Blot 
 +    * HLA-B27 in teenagers 
 +    * Mascarade diseases (leukemia, lymphoma) 
 +      * **CBC** 
 +====Work up based on history and exam findings==== 
 +  
 +  * Arthritis 
 +    * ANA 
 +  * Joint pain with chronic diarrhea and abdominal pain 
 +    * HLA-B27 
 +  * Rash 
 +    * Psoriasis  
 +      * rash areas are red, pink, or purple, dry, itchy, and scaly 
 +      * associated with arthritis  
 +    * Lyme 
 +      * erythema migrans  
 +        * red, blue or pink circular or oval with clear center, expands over several days, may reach up to 12 inches and have a raised border 
 +      * Travel to endemic areas, exposure to ticks 
 +      * Borrelia burgdorferi antibodies IgG, IgM  
 +  * Fever, Weight loss, fatigue, malaise, abdominal pain 
 +    * urinary β2 microglobulin, BUN, Creatinine, UA. ANA, HLA-B27, CBC 
 +  * Previous Strep throat (group A strep infection suspected 
 +    * Antistreptolysin O titers 
 +  
 +====Masquerades of Anterior Uveitis==== 
 +  * Leukemia 
 +  * [[retinoblastoma_international_classification|Retinoblastoma]] 
 +  * Juvenile Xanthogranuloma 
 + 
 +==== References ==== 
 +  * [[https://www.aao.org/education/disease-review/pediatric-anterior-uveitis|AAO Pediatric Anterior Uveitis]] 
 + 
 + 
 +{{tag>ddx uveitis}}