Epistemic_Statements  

CORD-19:b8ff0ebca4694d95758a53d05e58ac177778c7f4 JSONTXT 11 Projects

Annnotations TAB TSV DIC JSON TextAE

Id Subject Object Predicate Lexical cue
T1 0-81 Epistemic_statement denotes Identification of New Pathogens in the Intraocular Fluid of Patients With Uveitis
T2 94-210 Epistemic_statement denotes • PURPOSE: To determine infectious causes in patients with uveitis of unknown origin by intraocular fluids analysis.
T3 249-379 Epistemic_statement denotes Infections are thought to cause approximately 20% to 25% of cases; about 30% are associated with a noninfectious systemic disease.
T4 380-561 Epistemic_statement denotes Although for patient management and the efficacy of treatment, the differential diagnosis is crucial, in more than half of the uveitis patients the underlying cause remains unknown.
T5 738-887 Epistemic_statement denotes In recent years, a few other infectious agents have been implicated in the etiology of uveitis, most notably rubella virus and cytomegalovirus (CMV).
T6 1331-1890 Epistemic_statement denotes Included were pathogens previously associated with uveitis (enteroviruses, Epstein-Barr viruses [EBV] , human herpesvirus 6 [HHV6], influenza virus, rubella virus, Mycoplasma pneumoniae) and those causing conjunctivitis and/or keratitis or encephalitis (adenoviruses, coronaviruses, enteroviruses, influenza virus, parainfluenzaviruses, human parechovirus [HPeV], respiratory syncytial virus, Chlamydia pneumoniae, Chlamydia trachomatis) 1,5,8 -30 Our findings suggest that human parechovirus may be involved in the pathogenesis of infectious (kerato)uveitis.
T7 2151-2310 Epistemic_statement denotes The patients were classified using the uveitis nomenclature according to the recommendations of the Standardization of Uveitis Nomenclature working group 2005.
T8 7014-7151 Epistemic_statement denotes The patients with uveitis of unknown cause and a positive PCR result for rubella virus, HHV6, and human parechovirus are described below.
T9 8456-8580 Epistemic_statement denotes However, in comparison with HSV, VZV, CMV en Toxoplasma, intraocular antibody production against rubella virus was elevated.
T10 9038-9180 Epistemic_statement denotes Borrelia burgdorferi serum IgG and immunoblot were positive; however, a distinction between a past and an ongoing infection could not be made.
T11 9579-9668 Epistemic_statement denotes The OS had full visual acuity; however, some peripheral vitreous opacities were observed.
T12 9669-9844 Epistemic_statement denotes Because of the possible (previous) infection with Borrelia, the patient was treated with intravenous ceftriaxone and additionally with periocular steroids, but with no effect.
T13 10203-10265 Epistemic_statement denotes Therefore, rubella virusassociated FHUS could not be excluded.
T14 10266-10390 Epistemic_statement denotes Three months after vitrectomy the patient regained full visual acuity, although the keratic precipitates in his OD remained.
T15 11846-11981 Epistemic_statement denotes It was thought to be caused by HSV, but the patient did not respond to systemic and topical treatments with acyclovir and valacyclovir.
T16 12484-12648 Epistemic_statement denotes Aqueous analysis was negative for HSV, VZV, and Toxoplasma by both PCR and GWC and for CMV by PCR; however, retrospectively PCR was positive for human parechovirus.
T17 13319-13514 Epistemic_statement denotes The IOP initially normalized with laser iridotomy and local treatment; however, intermittent periods with IOP elevations up to 50 mm Hg were regularly encountered and trabeculectomy was required.
T18 14204-14555 Epistemic_statement denotes On examination KPs and cells in the anterior chamber and vitreous were noted with an active lesion located in the periphery of the retina (Table 3) EBV, the causative agent of infectious mononucleosis and several malignancies, has been implicated as a possible cause of uveitis and in primary ocular non-Hodgkin lymphoma of the central nervous system.
T19 14556-14719 Epistemic_statement denotes 16, 26, 35 In our study EBV was detected in the ocular fluid of 1 patient with anterior uveitis of unknown cause and in 2 patients with toxoplasma chorioretinitis.
T20 14990-15064 Epistemic_statement denotes The clinical significance of this phenomenon has not yet been established.
T21 15278-15404 Epistemic_statement denotes 18 intraocular antibody production analysis are required to determine whether EBV is a true cause of intraocular inflammation.
T22 15524-15593 Epistemic_statement denotes 38 Rubella virus has been associated with FHUS and FHUS-like uveitis.
T23 16181-16284 Epistemic_statement denotes However, absence of intraocular antibody production does not necessarily exclude intraocular infection.
T24 16575-16688 Epistemic_statement denotes 43 HHV6 has been implicated in ocular inflammation, most notably when the posterior part of the eye was affected.
T25 16795-16906 Epistemic_statement denotes Heterochromia is classically associated with FHUS but can develop in other viral infections such as HSV or VZV.
T26 16907-17186 Epistemic_statement denotes 44 The detection of HHV6 in the eye might not be a clinically relevant finding; however, like other (herpes)viruses, HHV6 can reside latently in cells of the lymphoid and myeloid lineage, and it may have entered the inflamed eye via immune cells, similar to HIV and possibly EBV.
T27 17187-17302 Epistemic_statement denotes 6, 18, 19, 36, 45 The role of HHV6 as a cause of anterior uveitis is inconclusive and further studies are required.
T28 17394-17502 Epistemic_statement denotes They may cause gastroenteritis, encephalitis, and flaccid paralysis in young children, but rarely in adults.
T29 17503-17760 Epistemic_statement denotes 29, 46 Ocular diseases attributable to other picornavirus infections, particularly enteroviruses such as echoviruses 11 and 19 and coxsackieviruses, have been published, but an association between parechoviruses and ocular disease has not been reported yet.
T30 17877-18067 Epistemic_statement denotes Unfortunately, intraocular antibody production could not be established as appropriate serologic assays are not available and there was not enough ocular fluid left to perform viral culture.
T31 18257-18327 Epistemic_statement denotes However, upon treatment with penicillin his ocular condition improved.
T32 18328-18427 Epistemic_statement denotes As this patient was HIV-positive, multiple uveitis entities may have contributed to ocular disease.
T33 18428-18598 Epistemic_statement denotes The other 3 patients all had unilateral anterior uveitis with corneal involvement and cells in the anterior chamber, which suggested an ocular viral infection (Table 3) .
T34 18599-18715 Epistemic_statement denotes Further research is required to determine if HPeV plays a role in the pathogenesis of infectious (anterior) uveitis.
T35 18716-18815 Epistemic_statement denotes It is surprising to find a virus that is associated with disease in children in the eyes of adults.
T36 18816-18938 Epistemic_statement denotes However, other infections of childhood are known to cause intraocular disease in adults, as is the case for rubella virus.
T37 19071-19118 Epistemic_statement denotes There are several explanations for this result.
T38 19119-19171 Epistemic_statement denotes First, the uveitis might be of noninfectious origin.
T39 19172-19282 Epistemic_statement denotes Second, the number of DNA or RNA copies present in the ocular samples may have been below the detection level.
T40 19283-19411 Epistemic_statement denotes This may be attributable to the low amount of input nucleic acid, which is inherent to diagnostic assays with intraocular fluid.
T41 19412-19530 Epistemic_statement denotes Alternatively, the time of sampling may have been such that the causative agent had already been cleared from the eye.
T42 19531-19693 Epistemic_statement denotes In this case, other diagnostic approaches may be more useful, such as the detection of intraocular antibody production by Goldmann-Witmer coefficient calculation.
T43 19694-19925 Epistemic_statement denotes It is known, also for systemic and neurologic viral infections, that a PCR assay is most sensitive early in infection, whereas antibody can be detected over a much longer period of time and thus provide a wider window of detection.
T44 19926-20035 Epistemic_statement denotes 2, 43, 47, 48 Finally, it may be that other pathogens not covered by our assays were involved in these cases.
T45 20036-20176 Epistemic_statement denotes Our study addressed multiple infectious causes in patients with undiagnosed uveitis and revealed a possible new cause of infectious uveitis.
T46 20177-20287 Epistemic_statement denotes Further investigations are required to narrow the diagnostic gap in patients with presumed infectious uveitis.