Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis
Abstract Background Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). Case presentation We retrospectively...
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BMC
2018-03-01
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| Series: | BMC Ophthalmology |
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| Online Access: | http://link.springer.com/article/10.1186/s12886-018-0740-3 |
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| author | Hisae Nakahara Toshikatsu Kaburaki Rie Tanaka Junko Matsuda Mitsuko Takamoto Kazuyoshi Ohtomo Kimiko Okinaga Keiko Komae Jiro Numaga Yujiro Fujino Makoto Aihara |
| author_facet | Hisae Nakahara Toshikatsu Kaburaki Rie Tanaka Junko Matsuda Mitsuko Takamoto Kazuyoshi Ohtomo Kimiko Okinaga Keiko Komae Jiro Numaga Yujiro Fujino Makoto Aihara |
| author_sort | Hisae Nakahara |
| collection | DOAJ |
| description | Abstract Background Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). Case presentation We retrospectively reviewed the clinical records of five patients who first visited the Uveitis Clinic of the University of Tokyo Hospital between 2009 and 2013, were diagnosed with FU and underwent a vitrectomy for removal of dense vitreous opacity. All were diagnosed as FU by ocular findings and elevation of Goldmann-Witmer coefficient (GWC) value for the rubella virus (RV) antibody. In examinations of the vitreous body, cytological diagnosis, elevation of IL-10/IL-6 ratio, and the kappa/lambda ratio in flow cytometry findings were negative in all cases, whereas monoclonal immunoglobulin heavy chain (IgH) gene rearrangement was positive in 4 cases and negative in 1 case. Conclusions Although monoclonal IgH gene rearrangement is thought to be a reliable biomarker for PVRL, a high percentage of vitreous specimens from our FU patients showed pseudo-positive results. Ophthalmologists must take care regarding possible pseudo-positive findings when performing differential diagnosis between FU and PVRL. Combinations of results of cytological diagnosis, IL-10/IL-6 ratio, kappa/lambda ratio, and IgH gene rearrangement may be necessary for a definitive diagnosis of PVRL and differentiation from FU. |
| first_indexed | 2024-12-19T03:26:44Z |
| format | Article |
| id | doaj.art-df4d683a51224638aaca3256535a717c |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-19T03:26:44Z |
| publishDate | 2018-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-df4d683a51224638aaca3256535a717c2022-12-21T20:37:36ZengBMCBMC Ophthalmology1471-24152018-03-011811610.1186/s12886-018-0740-3Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitisHisae Nakahara0Toshikatsu Kaburaki1Rie Tanaka2Junko Matsuda3Mitsuko Takamoto4Kazuyoshi Ohtomo5Kimiko Okinaga6Keiko Komae7Jiro Numaga8Yujiro Fujino9Makoto Aihara10Department of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, Nerima Hikarigaoka HospitalDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineDepartment of Ophthalmology, Tokyo Metropolitan Geriatric Hospital and Institute of GerontologyDepartment of Ophthalmology, Japan Community Healthcare Organization Tokyo Shinjuku Medical CenterDepartment of Ophthalmology, University of Tokyo Graduate School of MedicineAbstract Background Fuchs’ uveitis (FU) is occasionarlly complicated with heavy vitreous opacity. We have performed vitrectomy procedures to remove vitreous opacity in affected patients as part of differential diagnosis for primary vitreoretinal lymphoma (PVRL). Case presentation We retrospectively reviewed the clinical records of five patients who first visited the Uveitis Clinic of the University of Tokyo Hospital between 2009 and 2013, were diagnosed with FU and underwent a vitrectomy for removal of dense vitreous opacity. All were diagnosed as FU by ocular findings and elevation of Goldmann-Witmer coefficient (GWC) value for the rubella virus (RV) antibody. In examinations of the vitreous body, cytological diagnosis, elevation of IL-10/IL-6 ratio, and the kappa/lambda ratio in flow cytometry findings were negative in all cases, whereas monoclonal immunoglobulin heavy chain (IgH) gene rearrangement was positive in 4 cases and negative in 1 case. Conclusions Although monoclonal IgH gene rearrangement is thought to be a reliable biomarker for PVRL, a high percentage of vitreous specimens from our FU patients showed pseudo-positive results. Ophthalmologists must take care regarding possible pseudo-positive findings when performing differential diagnosis between FU and PVRL. Combinations of results of cytological diagnosis, IL-10/IL-6 ratio, kappa/lambda ratio, and IgH gene rearrangement may be necessary for a definitive diagnosis of PVRL and differentiation from FU.http://link.springer.com/article/10.1186/s12886-018-0740-3Fuchs’ uveitisIgH gene rearrangementIntraocular lymphomaVitrectomyVitreous opacity |
| spellingShingle | Hisae Nakahara Toshikatsu Kaburaki Rie Tanaka Junko Matsuda Mitsuko Takamoto Kazuyoshi Ohtomo Kimiko Okinaga Keiko Komae Jiro Numaga Yujiro Fujino Makoto Aihara Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis BMC Ophthalmology Fuchs’ uveitis IgH gene rearrangement Intraocular lymphoma Vitrectomy Vitreous opacity |
| title | Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis |
| title_full | Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis |
| title_fullStr | Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis |
| title_full_unstemmed | Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis |
| title_short | Monoclonal immunoglobulin heavy chain gene rearrangement in Fuchs’ uveitis |
| title_sort | monoclonal immunoglobulin heavy chain gene rearrangement in fuchs uveitis |
| topic | Fuchs’ uveitis IgH gene rearrangement Intraocular lymphoma Vitrectomy Vitreous opacity |
| url | http://link.springer.com/article/10.1186/s12886-018-0740-3 |
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