Ocular manifestations in Blau syndrome associated with a CARD15/Nod2 mutation. 2003

Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.

OBJECTIVE To report cases of Blau syndrome with a CARD15/Nod2 mutation. METHODS Observational and interventional case report. METHODS A 10-year-old Japanese boy (proband) was seen with secondary angle-closure glaucoma (iris bombe), uveitis, skin rashes, and camptodactyly. His sister had posterior synechia and camptodactyly. She had iritis in both eyes during the follow-up period. Both eyes of the father were phthisical because of granulomatous uveitis and secondary glaucoma. The father also had camptodactyly. METHODS Surgery was performed to release the iris bombe. Ocular inflammation was treated by topical and systemic steroids. Biopsy specimens from the skin rash and from the iris (from iridectomy) were obtained from the proband. Genetic analyses were performed on the proband, his sister, and their mother for a CARD15/Nod2 mutation. METHODS Clinical features, pathologic findings of the skin and iris specimens, and genetic analysis of the CARD15/Nod2 gene. RESULTS Phacoemulsification, intraocular lens implantation, and peripheral iridectomy released the iris bombe. The biopsy specimen from the skin rash showed noncaseating, granulomatous infiltration with epithelioid cells and lymphocytes. The iridectomy specimen showed nonspecific inflammation. Systemic and topical steroid therapy partly reduced the ocular inflammation. Genetic analyses showed that the proband and his sister had an R334W mutation in the CARD15/Nod2 gene, but their mother was of the wild type. CONCLUSIONS Blau syndrome should be considered in the differential diagnosis of childhood uveitis. Genetic analysis of the CARD15/Nod2 gene is helpful in the diagnosis.

UI MeSH Term Description Entries
D007500 Iritis Inflammation of the iris characterized by circumcorneal injection, aqueous flare, keratotic precipitates, and constricted and sluggish pupil along with discoloration of the iris. Iritides
D007592 Joint Diseases Diseases involving the JOINTS. Arthropathies,Arthropathy,Joint Disease
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002352 Carrier Proteins Proteins that bind or transport specific substances in the blood, within the cell, or across cell membranes. Binding Proteins,Carrier Protein,Transport Protein,Transport Proteins,Binding Protein,Protein, Carrier,Proteins, Carrier
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005076 Exanthema Diseases in which skin eruptions or rashes are a prominent manifestation. Classically, six such diseases were described with similar rashes; they were numbered in the order in which they were reported. Only the fourth (Duke's disease), fifth (ERYTHEMA INFECTIOSUM), and sixth (EXANTHEMA SUBITUM) numeric designations survive as occasional synonyms in current terminology. Rash,Skin Rash,Exanthem,Rash, Skin
D005260 Female Females
D005938 Glucocorticoids A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

Related Publications

Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
December 2006, American journal of ophthalmology,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
September 2010, Ophthalmic genetics,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
January 2012, Molecular vision,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
February 2005, The Journal of rheumatology,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
April 2011, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
June 2005, European journal of human genetics : EJHG,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
November 2016, Pediatric dermatology,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
February 2021, Children (Basel, Switzerland),
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
April 2007, Arthritis and rheumatism,
Toru Kurokawa, and Takanobu Kikuchi, and Kouichi Ohta, and Hiroki Imai, and Nagahisa Yoshimura
November 2020, Current opinion in ophthalmology,
Copied contents to your clipboard!