Corneal deposits and penetrating keratoplasty in a patient with hyperparathyroidism, hyperlipidaemia and multiple myeloma

Abstract

HTL V -1 infection is strongly linked to the subse­ quent development of adult T-cell leukaemia/lym­ phoma and HTLV-I associated myelopathy (HAM), which is also referred to as tropical spastic parapar­ esis (TSP). It is also associated with other inflamma­ tory conditions but causes asymptomatic lifelong infection in the majority of individuals.1-3 Ocular manifestations associated with HTL V-I infection have been documented, particularly in Japan, and include a steroid-resistant vasculitis4 and a granu­ lomatous or non-granulomatous uveitis.5 However, the exact role of HTL V-I in the pathogenesis of these disorders remains uncertain.6 In keeping with previous reports, our patients' anterior uveitides resolved completely with topical steroids. However, the development in case 1 of HAM 3 months after the initial presentation is in contrast with the results of a recent study of 32 patients with HTLV-I associated uveitis in which no patient developed neurological disease. Anterior uveitis has been described in patients with pre­ existent HAMITSP? HTL V-I is endemic in Japan, the Caribbean, Melanesia, Central Africa and parts of Central and South America, and in peoples who have migrated from these regions. Thus amongst the Afro-Carib­ bean community in the United Kingdom, the prevalence of HTLV-I is 2%,8 although its preva­ lence in those with uveitis is unknown. The infection may be acquired by vertical transmission, as in case 2, and this emphasises the importance of a family history in the diagnosis and counselling of patients found to be HTLV-I positive. Although the cause of uveitis in these two cases was ascribed to HTLV-I infection without intra­ ocular biopsy, they highlight the need to consider HTLV-I infection in patients belonging to at-risk groups who present with uveitis of unknown aetiol­ ogy, and the need for further studies into the prevalence of positive HTL V -I serology in such patients.

DOI: 10.1038/eye.1996.115

Cite this paper

@article{McElvanney1996CornealDA, title={Corneal deposits and penetrating keratoplasty in a patient with hyperparathyroidism, hyperlipidaemia and multiple myeloma}, author={Andrena M McElvanney and Hemanta Adhikary}, journal={Eye}, year={1996}, volume={10}, pages={522-525} }