Immunohistochemical Study of Chronic Nongranulomatous Anterior Uveitis in Juvenile Idiopathic Arthritis
Received 4 November 2007; received in revised form 13 February 2008; accepted 25 March 2008. published online 21 May 2008.
Purpose
To provide a detailed immunohistochemical analysis of juvenile idiopathic arthritis (JIA)-associated anterior uveitis.
Design
Interventional case report.
Participant
One patient.
Intervention
A 12-year-old patient had recurrent pauciarticular JIA and smoldering anterior uveitis in the right eye. Despite treatment with local and systemic corticosteroids and an anti–tumor necrosis factor agent, the right eye became hypotonous and painful and eventually was enucleated. The clinical history and histopathologic and immunohistochemical analyses of the enucleated globe were reviewed.
Main Outcome Measures
Histopathologic and immunohistochemical features of JIA-associated anterior uveitis.
Results
The iris and ciliary body showed nongranulomatous chronic inflammation predominantly made up of plasma cells, Russell bodies, and plasmacytoid lymphocytes. The ciliary processes and pars plana ciliaris showed focal aggregates of CD20-positive cells with several CD3- and CD8-positive cells and occasional CD4- and CD68-positive cells. Pancytokeratin stain showed ciliary epithelial proliferation admixed with lymphocytes. The iris revealed κ-positive cells within the stroma and λ-positive cells on the surface. The iris infiltrate primarily was made up of immunoglobulin (Ig) G-positive cells with occasional IgA- and IgM-positive cells. The anterior chamber exudate was mainly positive for IgG and IgA.
Conclusions
The immunohistochemical findings suggest that JIA-associated nongranulomatous iridocyclitis is a primarily B-cell-infiltrative process.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any materials discussed in this article.
Available online: May 21, 2008.
1A. Ray Irvine Ocular Pathology Laboratory, the Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California
2Children's Retina Institute, Los Angeles, California
Correspondence: Narsing A. Rao, MD, Doheny Eye Institute, 1450 San Pablo Street, DVRC 211, Los Angeles, CA 90033
Manuscript no. 2007-1434.
Financial Disclosure(s): None of the authors has a proprietary interest in the subject of this manuscript.
Supported by Research to Prevent Blindness, Inc., New York, New York.
ABSTRACT