Charité Clinical Journal Club (English) by Fred Luft - 31.10.2018

The N Engl J Med image of the week shows a 52-year-old man who presented to the emergency department with painless, bloody tears from both eyes. The bleeding had begun spontaneously approximately 2 hours earlier, had lasted a few minutes, and had recurred just before presentation. He was taking captopril for mild hypertension, and his blood pressure was normal. The clinical examination revealed slight conjunctival hyperemia without periorbital or palpebral edema. The patient had
normal vision and extraocular movements. Which of the following is not a cause of hemolacria? You are offered hemangioma, infection, adverse reaction to antibiotics, trauma, and retrograde epistaxis. We go over this condition, since hemolacria in the middle ages would have resulted in being burned at the stake as a witch, elevation to sainthood, or both. Cystic fibrosis, known in Germany by its older name, mucoviscidosis is an autosomal recessive mutation in the chloride channel, CFTR, and is the commonest genetic disease in Germany. Treatments to date include a potentiator (ivacaftor), which increases CFTR channel opening at the cell surface, and correctors (lumacaftor and tezacaftor), which increase the amount of CFTR protein at the cell surface...