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04 September 2019 : Case report  Saudi Arabia

Asymmetrical Ocular Manifestations of Nephropathic Cystinosis; A Case Report

Rare coexistence of disease or pathology

Hala A. Helmi1BCDEFG, Jeylan El Mansoury12ABDE, Selwa Al Hazzaa12AG, Abdulaziz Al Zoba2CG, Qais S. Dirar12ABCDEG*

DOI: 10.12659/AJCR.916737

Am J Case Rep 2019; 20:1308-1313

Abstract

BACKGROUND: Infantile nephropathic cystinosis is the most common and severe variant of cystinosis, which is a rare autosomal recessive condition related to a defect in the transportation of the protein cystine resulting in its deposition in various organs. Due to the rarity of this condition, only 1 case with extensive ocular involvement has been found in the English-language literature. Here, we report a second such case to highlight the significance of early diagnosis in avoiding devastating but preventable vision loss.

CASE REPORT: We describe the extensive asymmetrical ocular involvement in a 22-year-old woman who had nephropathic cystinosis since childhood. Despite frequent follow up and systemic and topical cysteamine therapy, she developed ocular complications, including increased intraocular pressure, uveitis, and retinal changes with complete loss of vision in her left eye. In addition, her general condition requires a renal transplant in the near future.

CONCLUSIONS: Ophthalmologists should be aware of cystinosis and the sequalae of ocular involvement in this disease, despite its rarity. Identification of the earliest corneal deposits should not be overlooked, especially in the context of other systemic manifestations that are indicative of the nephropathic variant of cystinosis.

Keywords: Corneal Diseases, Cysteamine, Cystinosis, Intraocular Pressure, Saudi Arabia, uveitis, Blindness, Ocular Hypertension, young adult

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923