What is the role of lab tests in the workup of peripheral ulcerative keratitis (PUK)?

Updated: Jun 11, 2019
  • Author: Ellen N Yu-Keh, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Laboratory tests used to evaluate peripheral ulcerative keratitis (PUK) should focus on the suspected systemic disease, as follows: [4]

  • Complete blood cell (CBC) count
  • Urinalysis (UA), blood urea nitrogen (BUN), and creatinine
  • Erythrocyte sedimentation rate (ESR)
  • Rheumatoid factor (RF); positive in 80% of patients with associated RA [4, 25]
  • Angiotensin-converting enzyme (ACE); elevated in sarcoidosis
  • Antinuclear antibodies (ANA); positive in patients with SLE and RA
  • Antibody to double-stranded DNA (anti-dsDNA); associated with SLE
  • Antibodies to small nuclear ribonucleoprotein-Sm (anti-Sm); associated with SLE
  • Antibodies to small nuclear ribonucleoproteins-RNP (anti-RNP); associated with SLE
  • Antineutrophil cytoplasmic antibodies (ANCA); C-ANCA sensitivity of 96% for active generalized GPA, 67% for active regional disease, and 32% for GPA in full remission after initial regional symptoms [4, 6, 26, 27, 28]
  • Circulating immune complex (CIC) - Raji cell assay; C-1q binding assay
  • Anti-type II antibodies; associated with RP
  • Complement - C3 and C4, CH50; consumed in patients with SLE
  • Hepatitis B surface antigen (HBsAg); present in 40% of patients with PAN
  • Fluorescent treponemal antibody-absorption (FTA-ABS) for syphilis

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