Intermediate Uveitis

[Concerned Grandmother]

My 12-year old granddaughter was diagnosed with Intermediate Uveitis about 9 months ago (at age 11).  She also had a partially detached retina in the opposite eye.  She underwent steroid injections in her eye for IU.  A follow-up visit yesterday showed a decrease in floaters, but the inflammation was a little worse.   Her blurred vision has increased. She's scheduled for another injection and the doctor will also use cryotherapy to hopefully stop the progression.  My concern is that from everything I've read on the internet, intermediate uveitis could be a precursor for MS.  My brother (her great uncle) has relapsing/remitting MS and he was first diagnosed with MS after he developed optic neuritis.  Also, my brother and I have two female first cousins, one from each side of the family, who have MS.  Should my daughter mention to the doctor our family history of MS?  Should we insist on an MRI of her brain and spine?  I know there is early-onset MS which occurs before age 16.  She had bloodwork done after the IU diagnosis to rule out rheumatoid arthritis.  My granddaughter has a history of asthma, but otherwise is in great health.  She runs track, plays softball, dances, etc.  I am just so worried about her vision and the possibility that her IU is the first symptom of something far worse.

[patsy10]

Uveitis is associated with lyme disease.  I would have her tested.  It would be very rare for MS to show up at this age.

[Quixotic1]

Actually I think your grandaughter's doctors definitely need to know of the strong family history.  Not to contradict Patsy10, childhood onset MS is well-know and fairly well studied world-wide.  Most of the large series of patients studied had a median age-onset of about 12 years.  It is most common in children between 10 and 17 years.  Of all confirmed MS cases, onset before age 17 makes up about 4% to 5%.

I am a retired pediatrician and the earliest I ever diagnosed MS was 15.  But I was aware of children who presented in their pre-teens.

And ocular problems, including uveitis, are one of the most frequent presenting problems of MS in children.

Even given the strong, close family history, Patsy is right.  You grandaughter deserves a full work up including adequate testing for Lyme and other tick-borne infections.

Here are a couple sites discussing very-early (less than age 17) age onset MS.

http://www.neurology.org/cgi/content/abstract/59/7/1006

http://www.geocities.com/HotSprings/3468/on-ms1.html#6

http://aapgrandrounds.aappublications.org/cgi/content/extract/10/3/32

http://pediatrics.aappublications.org/cgi/content/abstract/118/3/1133

Now most of these sites are just abstracts (summaries) of longer research articles which your child's doctors can read.  I can't, because most of the full articles are in subscription services which I can't afford.

Bottom line: with first symptoms at age 11 or 12, MS is definitely a possibility.

Good luck, Quix