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Infectious involvement in a tertiary center pediatric uveitis cohort
  1. Ymkje Marije Hettinga1,
  2. Jolanda Dorothea Francisca de Groot-Mijnes2,
  3. Aniki Rothova3,
  4. Joke Helena de Boer1
  1. 1Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Virology, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Ophthalmology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Ymkje Marije Hettinga, Department of Ophthalmology, University Medical Center Utrecht, E.03-136, Heidelberglaan 100, P.O. Box 85500, 3508 CX Utrecht, The Netherlands; Y.M.Hettinga{at}umcutrecht.nl

Abstract

Background/aims Studies of uveitis in children have focused primarily on non-infectious causes. To date, no systematic study of infectious uveitis in children has been conducted. We investigate the prevalence of infectious causes of uveitis in children and explore the diagnostic value of analysing aqueous humour.

Methods Retrospective cohort study in a tertiary referral centre for paediatric uveitis.

Medical records of 345 children with uveitis presenting from 1995 through 2010 were reviewed for infectious causes (by serology and aqueous humour analysis).

Results A diagnosis of infectious uveitis was established in 60/345 (17%) children. The most prevalent pathogen was Toxoplasma gondii (36/60; 60%), followed by viral infections (18/60; 30%). The most prevalent viral pathogen was varicella-zoster virus (VZV), representing 7/18 (39%) children. Viral causes were less often bilateral than other infectious causes (p=0.04). Specific IgG serum levels determined in 42/60 (70%) patients, were positive in 41/42 (98%). Aqueous humour was analysed for 24/60 (40%) patients and was positive in 18/24 (75%).

Conclusions An infectious cause of uveitis was identified in 17% of children with uveitis. T gondii and VZV were the most prevalent pathogens. We recommend analysing the aqueous humour of every child with vision-threatening uveitis of undetermined origin.

  • Aqueous humour
  • Child health (paediatrics)
  • Infection
  • Anterior chamber

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