Bilateral AdieÐ'ÐŽÐ'ЇS Pupils Associated With Thymoma And Thymic Autoantibodies

Bilateral AdieÐ'ÐŽÐ'Їs Pupils Associated with Thymoma and Thymic Autoantibodies

Abstract

Introduction: Blurred vision is a common ophtalmological symptom. AdieÐ'ÐŽÐ'Їs pupil is a rare condition which causes blurred vision. Bilateral AdieÐ'ÐŽÐ'Їs pupil might be a manifestation of an important occult disease. Case Report: We describe here a patient with bilateral AdieÐ'ÐŽÐ'Їs pupil associated with thymoma and thymic autoantibodies. Discussion: To our knowledge, this is the first reported case of bilateral AdieÐ'ÐŽÐ'Їs pupil associated with serum autoantibodies and a histologically proven thymoma.

Introduction

Blurred vision is a common ophtalmological symptom with a large spectrum of etiological causes [1] . Bilateral blurred vision is often iatrogenic and transient caused by eye medication [2,3]. However, a variety of causes must also be searched [1,2,3,4,5]. AdieÐ'ÐŽÐ'Їs pupil is a rare condition which causes blurred vision and it is benign when unilateral [2,3]. Bilateral AdieÐ'ÐŽÐ'Їs pupil is even less frequent and might be a manifestation of an important occult disease [6]. Here, we present a young woman with a very uncommon cause of bilateral AdieÐ'ÐŽÐ'Їs pupil.

Case Report

A 23 year old woman was admitted to the Department of Neurology with near vision difficulty and fatigue for 2 months . She was on neither eye drops nor any systemic medication. Her medical history revealed that she had applied to her physician with left shoulder pain six mounths ago, a mediastinal mass had been found and a thymectomy had been planned. She had had a 70mm/h ESR, moderate leukopenia (2600/mL) and thrombocytopenia (118 000/mL) at that time. After hematological investigations including bone marrow aspiration and biopsy all of which had appeared normal, the patient had been performed a thymectomy by left sided thoracotomy. The pathology had been benign thymoma (type B1) with cystic components. A left sided Horner's Syndrome had developed just after the surgery which almost had resolved by time. She had realised a six to eight kilogram weight loss by four months