Autoren:	Wasielica-Poslednik, Joanna Gericke, Adrian Desuki, Alexander Schlötzer-Schrehardt, Ursula Pfeiffer, Norbert Lisch, Walter
Titel:	Recurrence of paraproteinemic keratopathy after penetrating keratoplasty and its assessment with confocal microscopy
Online-Publikationsdatum:	19-Dez-2018
Erscheinungsdatum:	2018
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	Purpose To report on a case of recurrence of paraproteinemic keratopathy (PPK) associated with monoclonal gammopathy after bilateral penetrating keratoplasty. Observations Penetrating keratoplasty was performed on both eyes of a 45-year-old man due to bilateral progressive corneal stromal clouding. Recurrence of the corneal stromal opacities accompanied by a decrease in visual acuity was observed on slit-lamp examination already two years after penetrating keratoplasty. Confocal laser scanning microscopy (CLSM) of the corneal grafts performed three years after penetrating keratoplasty showed bilateral morphological changes identical to that found in the patient's corneas prior to penetrating keratoplasty. A hematological work-up revealed monoclonal gammopathy of type IgG kappa. The histochemical examination of the explanted corneas confirmed the diagnosis of PPK. Conclusions and importance Paraproteinemic keratopathy is an underdiagnosed ophthalmological condition, which may be associated with potentially life-threatening hematologic disorders. A hematological workup should be performed in patients with corneal opacities of uncertain etiology. Penetrating keratoplasty should be performed with caution in patients with monoclonal gammopathy due to the possibility of a very fast recurrence of PPK in the corneal graft. This is the first presentation of the recurrence of flake like PPK after penetrating keratoplasty assessed with CLSM.
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-257
URN:	urn:nbn:de:hebis:77-publ-587133
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY-NC-ND
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Zeitschrift:	American journal of ophthalmology : Case reports 11
Seitenzahl oder Artikelnummer:	87 91
Verlag:	Elsevier
Verlagsort:	Amsterdam
Erscheinungsdatum:	2018
ISSN:	2451-9936
URL der Originalveröffentlichung:	http://dx.doi.org/10.1016/j.ajoc.2018.06.014
DOI der Originalveröffentlichung:	10.1016/j.ajoc.2018.06.014
Enthalten in den Sammlungen:	JGU-Publikationen