| Presentation preference | Poster presentation |
| Title | Eyes Unveil the Hidden: Ocular Manifestations as the First Clue to Microscopic Polyangiitis |
| Accept poster if oral is not possible ? | Yes |
| Purpose | To report a case of retinal vasculitis as first manifestation of microscopic polyangiitis |
| Methods | Medical record review |
| Results | A 22-year-old male patient complaining of low vision in both eyes, associated to lower limbs edema and painful bullous lesions on both ankles. Since chilhood, the patient has had recurrent episodes of abdominal pain and bloody diarrhea. Best corrected visual acuity was 20/125 in the right eye and 20/200 in the left eye. Slit lamp examination, both eyes revealed clear cornea and conjunctiva, trophic iris without synechiae, anterior chamber reaction of 1+ and anterior vitreous cells of 2+. Fundus exam revealed a pattern of occlusive vasculitis. Laboratory tests showed: negative serologies for HIV and syphilis; a glomerular filtration rate of 50 mL/min/1.73 m²; p-ANCA of 1/160; and positive anti-MPO. A biopsy of the skin lesions on the lower limbs revealed leukocytoclastic vasculitis with interstitial neutrophilic dermatitis. The diagnosis was confirmed as ANCA-associated vasculitis (microscopic polyangiitis). The patient was treated with cyclophosphamide (Cyclops regimen), methylprednisolone 1g daily for 3 days, and oral prednisone 60 mg/day in a tapering schedule. The patient is still under follow-up showing progressive improvement |
| Conclusion | ANCA-associated vasculitides represent a group of autoimmune diseases characterized by inflammation of small to medium-sized blood vessels. Ocular involvement can occur in a frequency between 16 and 20%. Possible manifestations include uveitis and retinal vasculitis. Ocular involvement may occur isolated and without detectable ANCA, preceding systemic manifestations, which highlights the critical role of the ophthalmologist in early diagnosis |
| Conflict of interest | No |
1
| Last name | OLIVEIRA |
| Initials of first name(s) | B.M. |
| Department | Department of Ophthalmology and Visual Science, Federal University of Sao Paulo |
| City | São Paulo, SP |
| Country | Brazil |
2
| Last name | TAVARES CAVALCANTE |
| Initials of first name(s) | J.L. |
| Department | Department of Ophthalmology and Visual Science, Federal University of Sao Paulo |
| City | São Paulo, SP |
| Country | Brazil |
3
| Last name | Souza |
| Initials of first name(s) | G.M. |
| Department | Department of Ophthalmology and Visual Science, Federal University of Sao Paulo |
| City | São Paulo, SP |
| Country | Brazil |
4
| Last name | Campelo |
| Initials of first name(s) | C.M. |
| Department | Department of Ophthalmology and Visual Science, Federal University of Sao Paulo |
| City | São Paulo, SP |
| Country | Brazil |
5
| Last name | Finamor |
| Initials of first name(s) | L.P. |
| Department | Department of Ophthalmology and Visual Science, Federal University of Sao Paulo |
| City | São Paulo, SP |
| Country | Brazil |
