Management of uveomeningitis in internal medicine: Proposal for a diagnostic work-up - Centre de recherche en cancérologie de Lyon (UMR INSERM 1052 ; CNRS 5286 ; Centre Léon Bérard) Accéder directement au contenu
Article Dans Une Revue La Revue de Médecine Interne Année : 2016

Management of uveomeningitis in internal medicine: Proposal for a diagnostic work-up

S. Abad
  • Fonction : Auteur
C. Terrada
  • Fonction : Auteur
S. Trad
  • Fonction : Auteur
D. Sene
  • Fonction : Auteur
P. Bielefeld
  • Fonction : Auteur
D. Saadoun
  • Fonction : Auteur

Résumé

Uveomeningitis relates to an inflammatory state extending from iris and ciliary bodies to the choroid behind the eye. Because of a close contact between eye and brain, and barrier disruption, the inflammation can spread into the central nervous system (CNS). We review the clinical manifestations of uveitis, which are known to provide helpful clues to the diagnosis and describe the infectious, inflammatory, and neoplastic conditions classically associated with the uveomeningitis. Inflammatory or auto-immune diseases are probably the most common clinically recognized causes of uveomeningitis associated with a significant pleiocytosis. These entities often cause inflammation of various tissues in the body, including ocular structures and the meninges (i.e., sarcoidosis, Behcet's disease, and Vogt-Koyanagi-Harada syndrome). The association of an infectious uveitis with an acute or a chronic meningo-encephalitis is unusual but occasionally the eye examination may suggest an infectious etiology or even a specific organism responsible for an uveomeningitis. One should consider the diagnosis of primary ocular-CNS lymphoma in patients of 40 years of age or older with bilateral uveitis, especially with prominent vitritis, showing poor response to corticosteroid therapy. Finally, an algorithm for the diagnostic approach of uveomeningitis is proposed
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Dates et versions

hal-01791293 , version 1 (14-05-2018)

Identifiants

Citer

S. Abad, C. Terrada, S. Trad, D. Sene, P. Bielefeld, et al.. Management of uveomeningitis in internal medicine: Proposal for a diagnostic work-up. La Revue de Médecine Interne, 2016, 37, pp.25-34. ⟨10.1016/j.revmed.2015.09.009⟩. ⟨hal-01791293⟩
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