PMID- 32448152
OWN - NLM
STAT- MEDLINE
DCOM- 20210407
LR  - 20210407
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 20
IP  - 1
DP  - 2020 May 24
TI  - A case of severe flare reaction observed in HLA B27 associated acute anterior 
      uveitis.
PG  - 201
LID - 10.1186/s12886-020-01472-3 [doi]
LID - 201
AB  - BACKGROUND: Anterior chamber flare reaction refers to the light reflection from 
      the protein in aqueous humor. We report a case of very severe flare reaction 
      observed in human leukocyte antigen (HLA)- B27 associated acute anterior uveitis 
      (AAU). CASE PRESENTATION: An age 43 male patient visited the uveitis clinic 
      complaining of decreased visual acuity in the right eye which developed 1 week 
      before. The detailed ophthalmic examination revealed very severe flare reaction 
      in the anterior chamber with diffuse conjunctival hyperemia in the right eye. 
      Pupil margin and iris details were barely observable. Oral prednisolone 20 mg 
      daily with topical 1% prednisolone acetate (Pred Forte, Allergan, CA) every 2 h 
      and 1% topical cyclopentolate (Cyclogyl, Alcon, TX) three times daily were 
      immediately prescribed. The next day, the flare reaction of the right eye 
      decreased significantly and inflammatory cells in the anterior chamber were 
      visible. Detailed fundus examination revealed no inflammatory signs on the retina 
      and ciliary body. Later, the blood test revealed positive HLA B27 and 
      autoantibodies against lupus anticoagulant with mild elevation of C reactive 
      protein. There were no signs for ankylosing spondylitis. Continued treatment and 
      tapering of topical 1% prednisolone acetate for 4 weeks led to the complete 
      resolution of the anterior uveitis. CONCLUSIONS: We experienced HLA-B27 AAU with 
      the feature of a very severe flare reaction. Conventional uveitis treatment was 
      successful to acquire the complete resolution of the inflammation.
FAU - Kim, Jae-Ik
AU  - Kim JI
AD  - Department of Ophthalmology, Dongguk University, Ilsan Hospital, 814, Siksadong, 
      Ilsan-dong-gu, Goyang, Gyunggido, 410-773, South Korea.
AD  - Sensory Organ Research Center, Dongguk University, Goyang, South Korea.
FAU - Park, Choul Yong
AU  - Park CY
AUID- ORCID: 0000-0002-3041-658X
AD  - Department of Ophthalmology, Dongguk University, Ilsan Hospital, 814, Siksadong, 
      Ilsan-dong-gu, Goyang, Gyunggido, 410-773, South Korea. oph0112@gmail.com.
AD  - Sensory Organ Research Center, Dongguk University, Goyang, South Korea. 
      oph0112@gmail.com.
LA  - eng
GR  - HI-15C1653/Korea Health Industry Development Institute/Republic of Korea
PT  - Case Reports
PT  - Journal Article
DEP - 20200524
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (HLA-B27 Antigen)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Anterior Chamber/*diagnostic imaging
MH  - Aqueous Humor/*metabolism
MH  - HLA-B27 Antigen/*immunology/metabolism
MH  - Humans
MH  - Male
MH  - Slit Lamp Microscopy
MH  - Uveitis, Anterior/*diagnosis/immunology
MH  - Visual Acuity
PMC - PMC7247201
OTO - NOTNLM
OT  - AAU
OT  - Acute uveitis
OT  - Flare
OT  - HLA-B27
OT  - Immune
COIS- The authors declare that they have no competing interests except that the author, 
      Choul Yong Park, serves as a member of editorial board of BMC Ophthalmology.
EDAT- 2020/05/26 06:00
MHDA- 2021/04/10 06:00
PMCR- 2020/05/24
CRDT- 2020/05/26 06:00
PHST- 2020/01/30 00:00 [received]
PHST- 2020/05/18 00:00 [accepted]
PHST- 2020/05/26 06:00 [entrez]
PHST- 2020/05/26 06:00 [pubmed]
PHST- 2021/04/10 06:00 [medline]
PHST- 2020/05/24 00:00 [pmc-release]
AID - 10.1186/s12886-020-01472-3 [pii]
AID - 1472 [pii]
AID - 10.1186/s12886-020-01472-3 [doi]
PST - epublish
SO  - BMC Ophthalmol. 2020 May 24;20(1):201. doi: 10.1186/s12886-020-01472-3.