Uveitis laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes. | There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes. Examples of tests that may demonstrate abnormal findings include [[CBC]], [[ESR]], [[CRP]], complete metabolic panel, iron studies, and serology titers.<ref name="pmid23803478">{{cite journal| author=Majumder PD, Sudharshan S, Biswas J| title=Laboratory support in the diagnosis of uveitis. | journal=Indian J Ophthalmol | year= 2013 | volume= 61 | issue= 6 | pages= 269-76 | pmid=23803478 | doi=10.4103/0301-4738.114095 | pmc=3744779 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23803478 }} </ref><ref name="pmid20029142">{{cite journal| author=Agrawal RV, Murthy S, Sangwan V, Biswas J| title=Current approach in diagnosis and management of anterior uveitis. | journal=Indian J Ophthalmol | year= 2010 | volume= 58 | issue= 1 | pages= 11-9 | pmid=20029142 | doi=10.4103/0301-4738.58468 | pmc=2841369 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20029142 }} </ref><ref name="pmid23803476">{{cite journal| author=Rathinam SR, Babu M| title=Algorithmic approach in the diagnosis of uveitis. | journal=Indian J Ophthalmol | year= 2013 | volume= 61 | issue= 6 | pages= 255-62 | pmid=23803476 | doi=10.4103/0301-4738.114092 | pmc=3744777 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23803476 }} </ref><ref name="pmid20404984">{{cite journal| author=Herbort CP| title=Appraisal, work-up and diagnosis of anterior uveitis: a practical approach. | journal=Middle East Afr J Ophthalmol | year= 2009 | volume= 16 | issue= 4 | pages= 159-67 | pmid=20404984 | doi=10.4103/0974-9233.58416 | pmc=2855658 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404984 }} </ref><ref name="pmid2178095">{{cite journal| author=Kijlstra A| title=The value of laboratory testing in uveitis. | journal=Eye (Lond) | year= 1990 | volume= 4 ( Pt 5) | issue= | pages= 732-6 | pmid=2178095 | doi=10.1038/eye.1990.104 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2178095 }} </ref> | ||
== Laboratory findings == | == Laboratory findings == | ||
There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes | There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes. Routine laboratory studies should be correlated with a carefully collected history and a precise physical examination. Routine laboratory tests that may be ordered and their respective findings include:<ref name="pmid23803478">{{cite journal| author=Majumder PD, Sudharshan S, Biswas J| title=Laboratory support in the diagnosis of uveitis. | journal=Indian J Ophthalmol | year= 2013 | volume= 61 | issue= 6 | pages= 269-76 | pmid=23803478 | doi=10.4103/0301-4738.114095 | pmc=3744779 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23803478 }} </ref><ref name="pmid20029142">{{cite journal| author=Agrawal RV, Murthy S, Sangwan V, Biswas J| title=Current approach in diagnosis and management of anterior uveitis. | journal=Indian J Ophthalmol | year= 2010 | volume= 58 | issue= 1 | pages= 11-9 | pmid=20029142 | doi=10.4103/0301-4738.58468 | pmc=2841369 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20029142 }} </ref><ref name="pmid23803476">{{cite journal| author=Rathinam SR, Babu M| title=Algorithmic approach in the diagnosis of uveitis. | journal=Indian J Ophthalmol | year= 2013 | volume= 61 | issue= 6 | pages= 255-62 | pmid=23803476 | doi=10.4103/0301-4738.114092 | pmc=3744777 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23803476 }} </ref><ref name="pmid20404984">{{cite journal| author=Herbort CP| title=Appraisal, work-up and diagnosis of anterior uveitis: a practical approach. | journal=Middle East Afr J Ophthalmol | year= 2009 | volume= 16 | issue= 4 | pages= 159-67 | pmid=20404984 | doi=10.4103/0974-9233.58416 | pmc=2855658 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20404984 }} </ref><ref name="pmid2178095">{{cite journal| author=Kijlstra A| title=The value of laboratory testing in uveitis. | journal=Eye (Lond) | year= 1990 | volume= 4 ( Pt 5) | issue= | pages= 732-6 | pmid=2178095 | doi=10.1038/eye.1990.104 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2178095 }} </ref> | ||
===Complete Blood Count with Differentials and Peripheral Blood Smear=== | ===Complete Blood Count with Differentials and Peripheral Blood Smear=== | ||
*A low hemoglobin or hematocrit with microcytosis or marginal normocytosis may be indicative of blood loss by inflammatory bowel disease, or any chronic inflammatory disorder. | *A low [[hemoglobin]] or [[hematocrit]] with microcytosis or marginal normocytosis may be indicative of blood loss by [[inflammatory bowel disease]], or any chronic inflammatory disorder. | ||
*[[Eosinophilia]] may be suggestive of underlying parasitic infections, or sarcoidosis. | *[[Eosinophilia]] may be suggestive of underlying [[parasitic]] infections, or [[sarcoidosis]]. | ||
*Elevated [[white blood cells]] with a left shift may be suggestive of an underlying infection. | *Elevated [[white blood cells]] with a [[left shift]] may be suggestive of an underlying infection. | ||
*Decreased white blood cell count may be indicative of an immunosuppressed state. | *Decreased [[white blood cell]] count may be indicative of an [[immunosuppressed]] state. | ||
===ESR and CRP=== | ===ESR and CRP=== | ||
*Elevated ESR and CRP may be suggestive of an underlying infection or inflammatory condition. | *Elevated [[ESR]] and [[CRP]] may be suggestive of an underlying infection or [[Autoimmune|inflammatory condition]]. | ||
===Iron studies=== | ===Iron studies=== | ||
*Low ferritin with a high TIBC is suggestive of chronic blood loss by inflammatory bowel disease. | *Low [[ferritin]] with a high [[TIBC]] is suggestive of chronic blood loss by inflammatory bowel disease. | ||
*High ferritin may be suggestive of anemia of chronic inflammatory conditions. | *High [[ferritin]] may be suggestive of anemia of chronic inflammatory conditions. | ||
===Complete Metabolic Panel=== | ===Complete Metabolic Panel=== | ||
*Elevated BUN or | *Elevated [[BUN]] or [[chromium]] may be suggestive of renal dysfunction in [[tubulointerstitial nephritis]] with uveitis (TINU) syndrome. | ||
*Liver function tests such as AST or ALT may be elevated if [[sarcoidosis]], miliary [[tuberculosis]], or [[Behcet's disease]] affect the liver | |||
===Serology tests=== | ===Serology tests=== | ||
*[[HLA]] subtyping: HLA-B27, HLA-A29, HLA-B9, HLA-B15 | *[[HLA]] subtyping: [[HLA-B27]], [[HLA-A29]], HLA-B9, HLA-B15 | ||
*[[Antinuclear antibody]] (ANA) | *[[Antinuclear antibody]] (ANA) | ||
*[[Anti-neutrophil cytoplasmic antibody]] (ANCA) | *[[Anti-neutrophil cytoplasmic antibody]] (ANCA) | ||
*[[Anti-dsDNA]] | *[[Anti-dsDNA]] | ||
*Venereal disease research laboratory (VDRL) or Rapid Plasma Reagin (RPR) for [[syphilis]] | *[[Toxoplasma]] or [[Toxocara]] [[IgG]] or [[IgM]] | ||
*Purified protein derivative (PPD) for [[tuberculosis]] | *Venereal disease research laboratory ([[VDRL]]) or Rapid Plasma Reagin ([[RPR]]) for [[syphilis]] | ||
*Lyme titer | *Purified protein derivative ([[PPD]]) for [[tuberculosis]] | ||
*HIV test | *[[Lyme]] titer | ||
*[[HIV]] test | |||
===Other Laboratory Findings=== | ===Other Laboratory Findings=== | ||
*Elevated levels of [[vitamin D]] or [[angiotensin converting enzyme]] (ACE) are suggestive of [[sarcoidosis]] | *Elevated levels of [[vitamin D]] or [[angiotensin converting enzyme]] (ACE) are suggestive of [[sarcoidosis]]. | ||
== References == | == References == | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Ophthalmology]] | |||
[[Category:FinalQCRequired]] | |||
[[Category:Emergency mdicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
Latest revision as of 00:37, 30 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]
Overview
There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes. Examples of tests that may demonstrate abnormal findings include CBC, ESR, CRP, complete metabolic panel, iron studies, and serology titers.[1][2][3][4][5]
Laboratory findings
There are no diagnostic lab findings associated with uveitis. The presence of certain non-specific laboratory findings, in the presence of uveitis, may be suggestive of certain underlying causes. Routine laboratory studies should be correlated with a carefully collected history and a precise physical examination. Routine laboratory tests that may be ordered and their respective findings include:[1][2][3][4][5]
Complete Blood Count with Differentials and Peripheral Blood Smear
- A low hemoglobin or hematocrit with microcytosis or marginal normocytosis may be indicative of blood loss by inflammatory bowel disease, or any chronic inflammatory disorder.
- Eosinophilia may be suggestive of underlying parasitic infections, or sarcoidosis.
- Elevated white blood cells with a left shift may be suggestive of an underlying infection.
- Decreased white blood cell count may be indicative of an immunosuppressed state.
ESR and CRP
- Elevated ESR and CRP may be suggestive of an underlying infection or inflammatory condition.
Iron studies
- Low ferritin with a high TIBC is suggestive of chronic blood loss by inflammatory bowel disease.
- High ferritin may be suggestive of anemia of chronic inflammatory conditions.
Complete Metabolic Panel
- Elevated BUN or chromium may be suggestive of renal dysfunction in tubulointerstitial nephritis with uveitis (TINU) syndrome.
- Liver function tests such as AST or ALT may be elevated if sarcoidosis, miliary tuberculosis, or Behcet's disease affect the liver
Serology tests
- HLA subtyping: HLA-B27, HLA-A29, HLA-B9, HLA-B15
- Antinuclear antibody (ANA)
- Anti-neutrophil cytoplasmic antibody (ANCA)
- Anti-dsDNA
- Toxoplasma or Toxocara IgG or IgM
- Venereal disease research laboratory (VDRL) or Rapid Plasma Reagin (RPR) for syphilis
- Purified protein derivative (PPD) for tuberculosis
- Lyme titer
- HIV test
Other Laboratory Findings
- Elevated levels of vitamin D or angiotensin converting enzyme (ACE) are suggestive of sarcoidosis.
References
- ↑ 1.0 1.1 Majumder PD, Sudharshan S, Biswas J (2013). "Laboratory support in the diagnosis of uveitis". Indian J Ophthalmol. 61 (6): 269–76. doi:10.4103/0301-4738.114095. PMC 3744779. PMID 23803478.
- ↑ 2.0 2.1 Agrawal RV, Murthy S, Sangwan V, Biswas J (2010). "Current approach in diagnosis and management of anterior uveitis". Indian J Ophthalmol. 58 (1): 11–9. doi:10.4103/0301-4738.58468. PMC 2841369. PMID 20029142.
- ↑ 3.0 3.1 Rathinam SR, Babu M (2013). "Algorithmic approach in the diagnosis of uveitis". Indian J Ophthalmol. 61 (6): 255–62. doi:10.4103/0301-4738.114092. PMC 3744777. PMID 23803476.
- ↑ 4.0 4.1 Herbort CP (2009). "Appraisal, work-up and diagnosis of anterior uveitis: a practical approach". Middle East Afr J Ophthalmol. 16 (4): 159–67. doi:10.4103/0974-9233.58416. PMC 2855658. PMID 20404984.
- ↑ 5.0 5.1 Kijlstra A (1990). "The value of laboratory testing in uveitis". Eye (Lond). 4 ( Pt 5): 732–6. doi:10.1038/eye.1990.104. PMID 2178095.