Theme: Autoimmune disorders

Options:
A. Psoriatic arthritis
B. Reiter syndrome
C. Rheumatoid arthritis
D. Steven-Johnson syndrome
E. Cicatricial pemphegoid
F. Polyarteritis nodusa
G. Systemic Lupus erythematosus
H. Ankylosing spondylitis
I. Systemic sclerosis
J. Tuberous sclerosis
K. Ulcerative colitis
L. Chron’s disease


Lead in statement: The following patients all presented with red-eyes. Please choose the most appropriate systemic diagnosis from the list above.

Stems:

1. A 55-year-old man with known spine problems presents with red-eyes. He was recently discharged from hospital after successful treatment of pulmonary infection. Blood tests showed raised ESR and positive HLA-B27. There was no history of previous eye problems.

2. A70-year-old woman presents to eye casualty with red-eyes. On examination she has multiple mouth ulcers which are healing without scarring. Slit-lamp examination reveals cicatrising conjunctivitis. She is HLA-B12 positive.

3. A 55-year-old man presents with a red eye. On questioning he gives a history of palpitation, joint pains and weight loss. Slit-lamp examination reveals a peripheral ulcerative keratitis. His blood pressure was 190/140 mm Hg. Blood tests reveal signs of renal impairment, additionally a test for hepatitis-B surface antigen was positive.