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Me.27 A - Les uvéites de causes rhumatismales
S Zrour (1); W Korbaa (1); M Younes (1); R Ghrissi (1); S Ben Yahia (1); S Attia (1); I Bejia (1); M Touzi (1); M Khairallah (1); N Bergaoui (1); - (1) Monastir - Tunisie;
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Résumé
Introduction

Les uvéites sont des affections assez fréquentes et de diagnostic urgent. On distingue : l'uvéite antérieure, l'uvéite postérieure et la panuvéite.

Matériels et Méthodes

A travers un travail rétrospectif, nous avons cherché la fréquence des rhumatismes inflammatoires chroniques (RIC) comme étiologie de l'uvéite chez les malades hospitalisés au service d'ophtalmologie de Monastir sur une période de 14 ans.

Résultats

L'étude a inclus 506 patients ayant une uvéite, d'âge moyen de 33,4 ans (4-80) et de sex ratio H/F 0,9. L'uvéite antérieure est la plus fréquente (36 %), suivie de l'uvéite postérieure (28 %), la panuvéite (21 %) et de l'uvéite intermédiaire (15 %).
Un RIC est à l'origine d'une uvéite antérieure dans 5,5 % des cas (28 patients). La spondylarthrite ankylosante est incriminée dans 9 cas (1,7 %), une spondylarthropathie indifférenciée dans 5 cas (1 %), une spondylarthropathie des MICI et un rhumatisme psoriasique chacun dans 4 cas (0,8 %), une arthrite chronique juvénile dans 3 cas (0,6 %), une polyarthrite rhumatoïde et une arthrite réactionnelle chacune dans un cas (0,2 %). L'uvéite est antérieure dans la majorité des cas : 92 % des cas (26/28). Elle est postérieure dans un cas de spondylarthropathie secondaire à une maladie de Crohn (4%). Un cas de panuvéite avec composante granulomateuse au cours d'une spondylarthrite ankylosante est observé (4%). Elle est aigue et unilatérale dans tous les cas. Elle est de nature granulomateuse dans uniquement 4 % des cas.

Conclusion

Les uvéites de causes rhumatismales sont souvent antérieures, surtout dues aux spondylarthropathies, suivies de l'arthrite chronique juvénile. La polyarthrite rhumatoïde est une cause exceptionnelle d'uvéite.

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