(BMJ)—A 26-yo man was referred to ophthalmology for an eye lesion found on routine exam. Findings: inferior iris lesion (black arrow) w/ small, pigmented, inflammatory cell deposits on inferior corneal endothelium (white arrows). Lab test and chest CXR confirmed the dx. What is it?
Juvenile xanthogranuloma
Sarcoidosis
Tuberculosis
Iris prolapse
Anterior uveitis
You are correct. The pt’s circulating angiotensin-converting enzyme was raised and bilateral hilar lymphadenopathy was seen on CXR, leading to dx of presumed sarcoidosis. Ocular manifestations of sarcoidosis are diverse and often the 1st recognized signs of dz. This pt’s iris granuloma resolved after 2mo of systemic corticosteroid tx.

BMJ 2018;363:k4793