iritis

[J022]

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[Mike Bartolatz]

you have anterior uveitis related to the HLA B27 gene. it can manifest as just anterior uveitis or it can also present with the following conditions:
ankylosing spondylitis, psoriasis/psoriatic arthritis, reactive arthritis, GI/irritable bowel disease: ulcerative colitis, Crohn's disease.
low back pain if present should have an Xray at minimum and prefferably a CAT scan or MRI with contrast to look for causes which can be many.
arthritis or lesions on the spine can cause back and limb problems.
very rarely Multiple sclerosis and Behcet's disease have been diagnosed when HLA B27 is present. this gene can also cause intermediate uveitis so a very comprehensive evaluation with a depressed scleral exam should be done to look for snowbanking along the pars plana and to look for cells in the anterior Vitreous jelly causing vitritis.
you would test negative for RF when HLA B27 is the cause of the arthritis. this is known as SERONEGATIVE SPONDYLOARTHROPATHY Or Enteropathic arthropathy when ulcerative colitis or Crohn's disease are present.
rarely Sarcoidosis is present as well but different mechanisms of inflammation are present when this multisystem disease process is found to be the cause.
swollen glands, such as in the neck or chest lymph nodes are often signs of sarcoidosis, systemic lupus erythematosus or sjogren's syndome.
ringing in the ears can be linked to Sarcoidosis, Menier's disease and cogan's syndrome.
your last line of symptoms with the possible CNS stuff can be seen in several conditions. Multiple sclerosis, sarcoidosis, sjogren's syndrome, Crohn's disease, Lyme disease etc. abdominal pain is found in Sarcoidosis, ulcerative colitis, crohn's disease, whipples disease.

you need to be seen by an Ocular Immunologist who will take all of your symptoms and do additional testing to confirm this and perhaps refer you to a rheumatologist, GI specialist, ENT specialist, and Neurologist to do appropriate testing and treatment. the eye is the only organ that one can see besides the skin without imaging. the ophthalmologist will guide treatment by response inside the eye and this will indicate dose of medications.

where do you live so that I can suggest the closest and whom I feel is the Best Ocular Immunologist near you to get this quieted down and into Remission. this constant smoldering witll lead to complications such as cataracts, glaucoma, vascularization of the retina, cystoid macular edema, epiretinal membrane formation etc. here is an article on intermediate uveitis which often presents with HLA B27 disease, it will confirm what i have written to you: http://emedicine.medscape.com/article/1208794-treatment

I hope this helps,
mike Bartolatz

[J022]

Thank you Mike for all the information.

I live a few hours north of Utica, NY. Both NYC and Boston are commutable to me (Boston is a little easier).

Thanks again. I am glad I have something to go on now.

Joyce

[Mike Bartolatz]

C. Stephen Foster, MD, FACS Background | Publications | Research | Clinical Trials
Founder and President, Massachusetts Eye Research and Surgery Institution Website
Founder and CEO, Ocular Immunology and Uveitis Foundation Website
Clinical Professor of Ophthalmology, Harvard Medical School
5 Cambridge Center, 8th floor
Cambridge, MA 02142
Tel: 617-621-6377 | Fax: 617-494-1430 | Support Group | Email

with Boston being closer, contact teh very best Ocular Immunologist in the World, Dr Foster. when you call tell them you need an expedited appointment if at all possible. I volunteer with Dr Foster's online support group as a moderator so he is aware of who I am. I know him personally as a friend and mentor. tell them I sent you from his online support group.


take care,
mike Bartolatz

[J022]

Wonderful, thank you!!