Patient with bilateral hilar lymphadenopathy, erythema nodosum, anterior uveitis likely has sarcoidosis
A 32-year-old woman comes to the emergency department due to right eye pain and redness. The symptoms started 2 days ago and have progressively worsened. The patient notes, "My right eye is blurry, and it hurts when I look at bright light." She has had no eye trauma or similar symptoms in the past. She has no prior medical conditions but has had several weeks of nonproductive cough. The patient does not use tobacco, alcohol, or illicit drugs. Vital signs are within normal limits. Right eye examination reveals conjunctival injection, particularly around the cornea. The right pupil is constricted and reacts sluggishly to light. Left eye examination is normal, but penlight examination of the left eye results in right eye discomfort. The lungs are clear to auscultation. The abdomen is soft and nontender with no hepatosplenomegaly. Skin examination shows several small, tender nodules on the shins. Chest radiography reveals bilateral hilar lymphadenopathy. Which of the following is the most likely cause of this patient's ocular symptoms?
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- sarcoidosis
- Sarcoidosis is a systemic inflammatory disease characterized by multiorgan noncaseating granulomas. Most patients with sarcoidosis seek medical attention due to pulmonary disease (eg, cough, dyspnea), but extrapulmonary manifestations in the eyes, skin, heart, and joints are common. Ocular disease occurs in approximately 25% of patients with sarcoidosis at some point during illness and is the presenting symptom in 5% of cases. Patient with bilateral hilar lymphadenopathy, erythema nodosum, anterior uveitis likely has sarcoidosis.
- uveitis conjunctivitis keratitis
- Patients with suspected anterior uveitis should be referred to an ophthalmologist for diagnosis. Investigation of the underlying cause is then required. Patient with bilateral hilar lymphadenopathy, erythema nodosum, anterior uveitis likely has sarcoidosis.