TY - JOUR
T1 - What's in a name?
AU - Chu, Chia Kai
AU - Morgan, Michael L.
AU - Almarzouqi, Sumayya
AU - Lee, Andrew G.
AU - Newman, Steven A.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - A 51-year-old man with rheumatoid arthritis and diabetes mellitus presented with new onset left-sided hemiparesis, left-sided neglect, and left-sided incongruous, denser inferiorly, homonymous hemianopsia. Magnetic resonance image of the brain showed prominent swelling of the right frontal, parietal, and occipital lobes greater than on the left with significant change in the fluid-attenuated inversion recovery signal in the gray matter. Perinuclear antineutrophil cytoplasmic antibodies titers were elevated, and skin biopsy demonstrating leukocytoclastic vasculitis. He showed marked clinical and radiographic improvement in association with recovery of vascular abnormalities after the initiation of prednisone, pulse therapy with methylprednisolone, and methotrexate. Clinicians should be aware of the possibility of neuro-ophthalmic manifestations of rheumatoid arthritis, including rheumatoid arthritis-related vasculitis causing homonymous hemianopsia.
AB - A 51-year-old man with rheumatoid arthritis and diabetes mellitus presented with new onset left-sided hemiparesis, left-sided neglect, and left-sided incongruous, denser inferiorly, homonymous hemianopsia. Magnetic resonance image of the brain showed prominent swelling of the right frontal, parietal, and occipital lobes greater than on the left with significant change in the fluid-attenuated inversion recovery signal in the gray matter. Perinuclear antineutrophil cytoplasmic antibodies titers were elevated, and skin biopsy demonstrating leukocytoclastic vasculitis. He showed marked clinical and radiographic improvement in association with recovery of vascular abnormalities after the initiation of prednisone, pulse therapy with methylprednisolone, and methotrexate. Clinicians should be aware of the possibility of neuro-ophthalmic manifestations of rheumatoid arthritis, including rheumatoid arthritis-related vasculitis causing homonymous hemianopsia.
KW - Autoimmune disease
KW - Cerebral vasculitis
KW - Homonymous hemianopsia
KW - P-ANCA antibodies
KW - Rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=84952874923&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84952874923&partnerID=8YFLogxK
U2 - 10.1016/j.survophthal.2015.07.002
DO - 10.1016/j.survophthal.2015.07.002
M3 - Article
C2 - 26212152
AN - SCOPUS:84952874923
VL - 61
SP - 95
EP - 101
JO - Survey of Ophthalmology
JF - Survey of Ophthalmology
SN - 0039-6257
IS - 1
ER -