Biomedical subjects

C Deuter

Publications and source records attributed to C Deuter.

4 recordsLinked to original sources

PubMed2006

Mycophenolate mofetil in the treatment of uveitis in children.

BACKGROUND: Mycophenolate mofetil (MMF) is a new immunosuppressive agent that effectively controls the intraocular inflammation in adults. PURPOSE: To assess the efficacy of MMF in uveitis in children and to analyse the possible side effects. PARTICIPANTS AND METHODS: A retrospective analysis was carried out on 17 children (32 eyes) with intraocular inflammation treated with MMF and followed up at the University Eye Hospital Tuebingen, Tuebingen, Germany, between 2000 and 2005. All children had chronic non-infectious uveitis and received MMF for at least 6 months. All patients were given steroids or other immunosuppressive agents before initiating treatment with MMF. RESULTS: 17 children (10 boys and 7 girls) with a mean age of 8 (range 2-13) years at the onset of uveitis were examined. The average duration of follow-up after initiation of MMF was 3 (range 2-5) years. A steroid-sparing effect was achieved in 88% of the patients. The oral prednisolone was successfully discontinued in 41% children and reduced to a daily dose of < or =5 mg in 47% of the children. 24% of the patients remained relapse-free during the treatment, but a reduction in the relapse rate was observed in all other patients except one. Visual acuity was increased or maintained in 13 children (76%). Mild side effects (headache, rash, gastrointestinal discomfort) occurred in 7 patients (41%) and were the cause of discontinuation of MMF in 1 patient. CONCLUSION: The results of our study are encouraging and suggest that MMF is an effective agent also in the treatment for uveitis in children, with marked steroid-sparing potential and an acceptable side effect profile.

Adolescent↗

PubMed2006

[Uveitis and the aging].

Uveitis can be found in all age groups, but the age of disease onset may provide important information on the etiology of the disease. New data on the epidemiology of uveitis disclose a higher incidence and prevalence in older patients then has previously been found. Masquerade syndromes which mimic uveitis may be found especially in younger and older patients. These have to be excluded from regular intraocular inflammation. Here, intraocular lymphoma plays a major role which is most often associated with severe clinical, diagnostic and therapeutic challenges. One of the major complications of uveitis is cataract formation. Keeping in mind the importance of pre- and postoperative treatment, even implantation of an intraocular lens in older patients with uveitis is currently a safe procedure.

Age Factors↗

PubMed2001

[Behçet's disease: uveitis-therapy with interferon alpha2a - prospective clinical study in 33 patients].

INTRODUCTION: Behçet's disease (BD) is a multisystem vasculitis of unknown origin. Visual outcome in BD is bad irrespective of therapy. We investigated in a prospective, open clinical trial wether interferon alpha2a (IFN alpha2a) is effective as single agent in severe ocular BD. PATIENTS AND METHODS: 33 patients (11 female, 22 male) with severe ocular BD (posterior uveitis/panuveitis), fulfilling the Criteria of the "International Study Group of Behçet's Disease", were treated with IFN alpha2a. Other immunosuppressive drugs were stopped at the beginning of interferon-therapy. Efficacy was evaluated by the uveitis scoring system (Ben Ezra et al.), visual acuity and BD activity score (Rigby et al.). RESULTS: In 32 (97 %) patients complete remission of the inflammatory changes occured. Mean posterior uveitis score fell from 3.7 to 0.4, visual acuity rose from 0.5 to 0.9, and mean BD activity score fell from 5.1 to 3.0 during a mean observation period of 28.6 months. There was only one non-responder. Side effects were hair loss (69 %), depression (36 %), itching (33 %), fibromyalgia (10 %), and the development of autoantibodies (21 %). Fever, arthralgia and headache occured in all patients, but only during the first weeks of therapy. CONCLUSION: IFN alpha2a seems to be very effective in ocular BD. Controlled randomized studies are warranted in order to prove the efficacy of IFN alpha2a in ocular BD and to compare it with other, established treatments, such as azathioprine or cyclosporin A.

Adult↗

PubMedDate not supplied

MAGIC or not MAGIC--does the MAGIC (mouth and genital ulcers with inflamed cartilage) syndrome really exist? A case report and review of the literature.

INTRODUCTION: In 1985, Firestein et al. described 5 patients with relapsing polychondritis and Behçet's disease (BD) and proposed the term "MAGIC" syndrome as an acronym for "Mouth and Genital ulcers with Inflamed Cartilage". We report on an additional case of this syndrome and critically review the literature. RESULTS: From 1985 to 2004 eleven cases of MAGIC syndrome were described. All patients had chondritis and oral aphthous ulcers, as well as ocular inflammation (mainly anterior uveitis or scleritis/episcleritis). Most patients also presented with genital ulcers and arthritis. In one case, aortic aneurysm, in another aortic insufficiency was described, one had meningoencephalitis, one had antiphospholipid syndrome and one was HIV positive. Before 1985, we could find 4 additional probable cases. Our own patient presented with oral and genital ulcers, auricular chondritis and episcleritis. HLA-typing was performed and revealed HLA-B*51, B*15, DRB1*04x and DRB1*11x. Only in one Japanese patient from the literature, HLA-typing was available and revealed HLA-B*56, B*62, DRB1*0406 and DRB1*0901. CONCLUSIONS: Relapsing polychondritis is associated with HLA-DRB1*04 suballeles, but not necessarily only with those being associated with RA (DRB1*0401 and 0404). In 2 MAGIC patients these suballeles were found. All patients described in the literature had typical polychondritis, but not all did fulfil the classification criteria for BD. Many features of both diseases overlap and are not specific. As polychondritis is associated with other inflammatory rheumatic conditions such as SLE, spondyloarthropathy, rheumatoid arthritis and systemic vasculitides in 30% of all cases, we suggest that MAGIC syndrome is not a disease entity, but merely the association of BD with polychondritis.

Behcet Syndrome↗