Management dilemma: QuantiFERON reversion in a young man with panuveitis
Purpose
To present a case who had panuveitis in the right eye and QuantiFERON positive at the first, and had QuantiFERON reversion after anti-tuberculosis treatment(ATT). To discuss how we manage patient with QuantiFERON reversion.
Methods
Case record of a 25 years old man who had panuveitis in the right eye and QuantiFERON positive. Visual acuity, intraocular pressure, fluorescein angiography, and spectral-domain optical coherence tomography were documented. The management process was also recorded. Papers about QuantiFERON change were reviewed.
Results
A 25 years old man had panuveitis in the right eye. His blood tests were within normal limits except QuantiFERON positive at another hospital, so he was treated as intraocular tuberculosis. However, after 9-month ATT, his panuveitis in the right eye was not improved and his left eye also developed panuveitis. We re-checked his QuantiFERON at our hospital, and it turned to negative. Under the impression of Bechet’s disease, the rheumatologist started to use golimumab. The patient’s uveitis in eyes became stable.
Conclusion
Progressive inflammation following ATT for presumed ocular TB is common. It generally resolves on escalation of steroid therapy. If cases do not respond to increased immunosuppression, it is need to be re-investigated other cause. Interpretation of serial QuantiFERON tests is confounded by immunological and technical variability, and it must be interpreted in conjunction with clinical findings and collaboration with other subspecialties.
Conflict of interest
No
Author 1
Last name
HSIA
Initials of first name(s)
NY
Department
Ophthalmology
City
Taichung
Country
Taiwan
Author 2
Last name
LIN
Initials of first name(s)
CJ
Department
Ophthalmology
City
Taichung
Country
Taiwan
Author 3
Last name
LIN
Initials of first name(s)
JM
Department
Ophthalmology
City
Taichung
Country
Taiwan
Author 4
Last name
CHEN
Initials of first name(s)
WL
Department
ophthalmology
City
Taichung
Country
Taiwan
Author 5
Last name
TSAI
Initials of first name(s)
YY
Department
Ophthalmology
City
Taichung
Country
Taiwan
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