Wydanie 4/2014
str. 60

Pseudoretinopatia Purtschera jako jeden z czynników ryzyka ostrego zapalenia trzustki o ciężkim przebiegu – opis przypadku i przegląd piśmiennictwa

Purtscher-like Retinopathy as One of the Risk Factors in Acute Severe Pancreatitis Development – Case Report and Review of the Literature

Joanna Roskal-Wałek, Michał Biskup

Oddział Okulistyczny z Salą Operacyjną Wojewódzkiego Szpitala Zespolonego w Kielcach
Kierownik: dr n. med. Magdalena Gierada


Summary: Purtscher-like retinopathy is a type of angiopathy, which may occur in the course of acute pancreatitis. The development of acute pancreatitis is associated with premature activation of pancreatic proenzymes. Active enzymes lead to autodigestion of the pancreas and surrounding tissues. Autodigestion of the pancreas releases a very strong local, and often generalized inflammatory reaction, and in which the process involving multiple pro-inflammatory mediators, kinin system, fibrinolysis and complement. Cytokines in the inflammatory response may cause microembolisation, initiate the development of intravascular coagulation consequently lead to multiple organ failure. Microembolization of retinal and choroidal arterioles caused by activation of the complement system is likely to be the main mechanism responsible for Purtscher-like retinopathy development.
We present a case of a patient diagnosed with Purtscher-like retinopathy which occurrence preceded the development of multiple organ failure in acute pancreatitis. Purtscher-like retinopathy may be one of the first manifestations of the transition of inflammation which is localized in the pancreas to systemic inflammation and in this way provide information of increased risk of severe acute pancreatitis. Routine examination of the fundus for changes characteristic of Purtscher-like retinopathy could be an additional parameter used in assessing the severity of acute pancreatitis.

Słowa kluczowe: pseudoretinopatia Purtschera, retinopatia Purtschera, ostre zapalenie trzustki, mikroemblizacja, niedokrwienie siatkówki.

Keywords: Purtscher-like retinopathy, Purtscher’s retinopathy, acute pancreatitis, microembolization, retinal ischemia.


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