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Postgraduate Medical Journal 2004;80:491; doi:10.1136/pgmj.2003.011197
Copyright © 2004 The Fellowship of Postgraduate Medicine.
Postgraduate Medical Journal 2004;80:491
© 2004 Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTION

Metabolism

Pigmented sclera: a diagnostic challenge?

V Mishra and L R Ranganath

Department of Clinical Chemistry, Royal Liverpool University Hospital, Liverpool, UK

Correspondence to:
Correspondence to:
Dr Vinita Mishra
Department of Clinical Chemistry, Royal Liverpool University Hospital, Liverpool L7 8XP, UK; vinita.mishra@rlbuht.nhs.uk

Submitted 13 June 2003

Accepted 17 July 2003


Answers on p 493.

The first 100% of the full text of this article appears below.

Figure 1Go shows the eyes of a 53 year old man who has suffered with severe generalised arthritis for more than 15 years, requiring left knee replacement at the age of 45 years. He has noticed dark urine on several occasions and passed many renal stones. His sister (aged 52 years) also has generalised arthritis especially in the large joints of the lower limbs and the back. In addition, she has been passing dark urine and has dark pigmentation of the cartilage of her ear (fig 2Go).


 


 

QUESTIONS

  1. What is the diagnosis in the male patient?
  2. Does his sister have the same condition?
  3. What further investigations would you perform to confirm your diagnosis?
  4. What are the clinical features of this disease?
  5. How would you manage this condition?


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Pigmented sclera: a diagnostic challenge?
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