A nurse practitioner inquired about a 25-year-old female who presented with 1 day of rapidly worsening unilateral eye pain and severe photo sensitivity. The patient also complained of fatigue, joint pain, low-grade temperature, and mucosal dryness.
On examination, the symptomatic eye showed an injected conjunctiva and a crystalline reflection when a fundal examination was attempted.
A diagnosis of uveitis was made, and a referral to rheumatology revealed laboratory findings that were positive human leukocyte antigen (+HLA) B-27, positive ribonucleoprotein antibody (+RNP), and anti-nuclear antibody (ANA) titer of >1:80, which, in conjunction with the uveitis, were consistent with a diagnosis of ankylosing spondylitis. (196-3)
Sherril Sego, FNP-C, DNP is a primary-care nurse practitioner at the Department of Veterans Affairs Medical Center in Kansas City, Mo.
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