From the Guidelines
Pelvicaliectasis and uveitis are two distinct conditions with different causes and treatment approaches, and their management should prioritize addressing the underlying causes and preventing complications. The causes of pelvicaliectasis include urinary tract obstruction from kidney stones, ureteropelvic junction obstruction, pregnancy, tumors, or congenital abnormalities, as well as vesicoureteral reflux, neurogenic bladder, and certain medications. On the other hand, uveitis can result from autoimmune disorders like rheumatoid arthritis, ankylosing spondylitis, and inflammatory bowel disease, infectious causes such as tuberculosis, herpes, toxoplasmosis, and syphilis, and systemic conditions like sarcoidosis and Behçet's disease, with some cases being idiopathic 1. Treatment for pelvicaliectasis focuses on addressing the underlying obstruction, while uveitis typically requires anti-inflammatory medications like corticosteroid eye drops, sometimes with immunosuppressants for severe or chronic cases, as recommended by recent guidelines 1. Key considerations in managing uveitis include the use of topical corticosteroids, cycloplegic agents, and in rare cases, systemic steroids, with infliximab considered for severe and treatment-refractory cases 1. Prompt diagnosis and treatment are essential for both conditions to prevent complications like kidney damage or vision loss, highlighting the importance of a comprehensive approach to managing these conditions. Some of the specific treatment recommendations for uveitis include:
- Topical corticosteroids, such as prednisolone 1% every 1-2 hours initially, then tapered
- Cycloplegic agents
- Systemic steroids in rare cases
- Infliximab for severe and treatment-refractory cases It is crucial to prioritize the most recent and highest quality evidence when making treatment decisions, and to consider the individual patient's needs and circumstances when developing a treatment plan 1.
From the Research
Causes of Uveitis
- Uveitis can be caused by infectious or non-infectious factors, with toxoplasmosis, herpes, tuberculosis, and HIV comprising 11% to 21% of infectious cases in high-income countries and 50% in low- and middle-income countries 2
- Non-infectious uveitis can be an expression of a systemic autoimmune condition, or it can be idiopathic 3
- Genetic factors, such as human leukocyte antigen-B27, and environmental factors, such as air pollution, can influence the incidence and prevalence of uveitis 2
- Systemic diseases, such as axial spondyloarthritis, can also be associated with uveitis, with 37% to 49% of uveitis cases being associated with systemic disease in the US and Europe 2
Causes of Pelvicaliectasis
- There is no direct evidence in the provided studies to suggest a cause for pelvicaliectasis, which is a condition characterized by the dilation of the renal pelvis and calyces.
- However, it is often associated with conditions that affect the urinary tract, such as kidney stones, tumors, or congenital abnormalities.