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Editors Selection IGR 7-3
Posner Schlossman Syndrome: Helicobacter pylori and Posner-Schlossman syndrome
Comment by Luca Rossetti on:
25012 Association between Helicobacter pylori infection and Posner-Schlossman syndrome, Choi CY; Kim MS; Kim JM et al., Eye, 2010; 24: 64-69
The etiology of Posner-Schlossman syndrome (PPS) still remains unclear. An association between PPS and a diagnosis of peptic ulcer was described in the late 80's by Knox in a sample of 32 PPS patients and the inflammation with the consequent circulation of antibodies and immune complexes and the cross-reaction with ocular tissues were proposed as possible explanations. In a prospective case-control study by Choi et al. (320), the association between Helicobacter pylori infection and PPS was tested. The group of 40 subjects with PPS showed a positive titre (> 15 U/ml) of H. pylori in 80% of the cases vs 56% in the control group, which is similar to the expected rate in a population with similar age distribution. A number of putative mechanisms through which H. pylori might be one of the causes of PPS are listed, mainly involving the circulation of antibodies and an autoimmune reaction. One important limitation of this case control is the small sample size and therefore its findings should be confirmed in bigger multicenter studies. The effect of the small sample is rather evident when one considers that, despite the fact that cases and controls were sex- and age-matched, the two groups were grossly unbalanced for the presence of diabetes, systemic hypertension, HbsAg and Anti-HbsAb. The fact that positivity to H. pylori was the only factor significantly associated with PPS in the multivariate analysis does not exclude the possibility of a spurious association due simply to sample selection and effect of chance. In conclusion, although these interesting findings are suggesting a possible role of H. Pylori infection in determining PPS, further evidence is needed to confirm this hypothesis.
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