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Bilateral Coats' response in a female patient leads to diagnosis of facioscapulohumeral muscular dystrophy.
[coats disease]
Facioscapulohumeral
dystrophy
(
FSHD
)
is
a
rare
autosomal
dominant
muscle
disease
that
affects
about
5
in
100
,
000
individuals
.
Retinal
vascular
changes
that
mimic
Coats
'
disease
have
been
described
in
previously
diagnosed
FSHD
.
We
report
a
diagnosis
of
FSHD
only
after
the
detection
of
a
rare
bilateral
Coats
'
response
in
a
female
patient
.
A
39
-
year
-old
asymptomatic
black
woman
presented
for
a
second
opinion
of
a
lesion
previously
diagnosed
as
an
isolated
hemangioma
in
the
left
temporal
retina
.
She
had
no
relevant
family
or
personal
health
history
.
She
was
not
born
prematurely
,
did
not
show
evidence
of
autoimmune
disease
,
and
had
a
normal
hemoglobin
electrophoresis
.
Examination
found
an
exudative
mass
in
the
left
temporal
retina
and
subtle
telangiectatic
vessels
in
the
right
temporal
retina
.
Optomap
®
(
Optos
®
,
Dunfermline
,
Scotland
)
fluorescein
angiography
found
multiple
areas
of
capillary
drop-out
,
arborization
,
and
telangiectatic
microaneurysms
in
both
eyes
(
left
eye
greater
than
right
eye
)
.
Genetic
testing
results
were
positive
for
a
deletion
of
tandemly
repeated
DNA
(
D
4
Z
4
repeats
)
in
chromosome
4
q
35
consistent
with
a
diagnosis
of
FSHD
.
A
prior
diagnosis
of
FSHD
alerts
the
clinician
to
look
for
a
Coats
'
response
in
the
retina
.
However
,
bilateral
Coats
'
disease
in
a
female
should
alert
the
clinician
to
test
for
FSHD
.
Diseases
Validation
Diseases presenting
"female patient"
symptom
achondroplasia
adrenal incidentaloma
alexander disease
aniridia
aromatase deficiency
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
coats disease
cohen syndrome
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dentinogenesis imperfecta
epidermolysis bullosa simplex
esophageal squamous cell carcinoma
fabry disease
holt-oram syndrome
hydrocephalus with stenosis of the aqueduct of sylvius
kallmann syndrome
kindler syndrome
krabbe disease
lamellar ichthyosis
liposarcoma
lymphangioleiomyomatosis
malignant atrophic papulosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
x-linked adrenoleukodystrophy
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