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SAT0041 Validity of the application of a diagnostic protocol according to patterns of clinical presentation of uveitis to establish diagnosis
  1. G Bonilla Hernán1,
  2. S Muñoz Fernandez1,
  3. V Hidalgo2,
  4. J Fernandez Melón1,
  5. A Schlincker2,
  6. A Fonseca2,
  7. F Gamero Ruiz1,
  8. B Damas2,
  9. E Martín Mola1
  1. 1Rheumatology
  2. 2Oftalmology, Hospital La Paz, Madrid, Spain

Abstract

Objectives To validate the efficiency of the application of a diagnostic protocol based on the patterns of presentation of uveitis to establish the diagnosis.

Methods Our Uveitis Clinic is composed of a multidisciplinary team of Ophatalmologists and Rheumatologist.

We defined a clinical diagnostic protocol for the uveitis, based on the frequency of syndromes found in the literature in each clinical pattern of uveitis and the symptoms of the patients. We routinarelly performed a careful history, a complete ophtalmologic examination, hemogram, biochemistry, ESR, a fluorescent treponemal antibody absorption test, an urinary test and a chest X Ray. Other diagnostic procedures were ordered according to a established protocol based on the clinic patterns of presentation of uveitis. Data from the patients were prospectively recorded from June of 1997 to October 2000.

Results 366 patients were included, 40 of them (10.7%) were lost of follow-up,146 of the 336 who completed the study were diagnosed of idiopahatic uveitis (43.4%),70 (21%) had some type of spondyloarthopaty (30 patients were diagnosed in our uveitis clinic), 33 (9.8%) were secondary to infections (23 herpes, 6 toxoplasmosis,3 tuberculosis, 1 candida), 3 were masquerade syndromes (1 lung cancer and 2 linphoproliferative diseases), 6 (1.7%) were traumatic, 47 (14%) were ophtalmologic syndromes, 21 (6.25%) uveitis were secondary to other rheumatic diseases (8 Behçet diseases,8 Sarcoidosis,4 Sjögren’s syndrome and one juvenile chronic arthritis) and 2 were TINU syndromes.

Conclusion We have achieved the etyology of the uveitis in 56.6%. A greater percentage than those found in other series in which the diagnostic procedures have not been prestablished. In addition, it could have a better cost-effective impact and avoid the number of consultations between different specialists. We believe that this is the first study in which a clinical protocol of diagnostic procedures has been validated in patients with uveitis.

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