BACKGROUND Bilateral Acute Depigmentation of the Iris (BADI) is a condition which was first described in a case series from Turkey by Tugal-Tutkin and Urgancioglu in (Graefes Arch Clin Exp Ophthalmol 244:742-6, 2006). The condition is characterized by bilateral acute depigmentation and discoloration of the iris stroma, pigment dispersion, and deposition of pigment in the angle. In our case we report a patient who developed BADI after receiving pitcher plant extract injections for chronic migraine, while her identical twin sister has normal iris architecture and pigmentation and never received any pitcher plant injections. CASE PRESENTATION Patient is a 41-year-old female with history of pitcher plant extract injections to her face for chronic migraine, who later developed bilateral depigmentation of the iris. She did not have any signs of anterior segment uveitis or iridocyclitis. She has an identical twin sister who maintained normal iris pigmentation during the entire course. CONCLUSIONS Bilateral Acute depigmentation of the is a recently discovered condition described in the literature in Turkish patients (Tugal-Tutkun and Urgancioglu, Graefes Arch Clin Exp Ophthalmol 244:742-6, 2006; Tugal-Tutkun et al., Ophthalmology 116(8):1552-7, 2009). This condition affects mainly young females and is characterized by acute bilateral stromal depigmentation, without other pathologic ocular findings. These patients usually maintain normal vision and do not develop significant glaucoma from pigment collecting in the anterior chamber angle. This condition can be mistaken for Fuchs' heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis. This is the first reported case in North America and is important for differentiation from the above pathologies. Our patient had a history of pitcher plant extract injections to the face but it is unclear if this is associated with our patient's development of BADI. As awareness of this condition progresses, a possible etiology may be elucidated.

中文翻译：

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两个同卵双胞胎之一的虹膜双侧急性色素沉着的病例。

背景技术虹膜的双侧急性脱色（BADI）是Tugal-Tutkin和Urgancioglu在来自土耳其的一系列病例中首次描述的病症（Graefes Arch Clin Exp Ophthalmol 244：742-6，2006）。该病的特征是虹膜基质的双侧急性脱色和变色，色素分散和角膜内色素沉积。在我们的案例中，我们报告了一名患者，该患者在接受针对慢性偏头痛的猪笼草提取物注射后发展为BADI，而她的同卵双胞胎姐姐的虹膜结构和色素沉着正常，从未接受任何猪笼草注射。病例介绍该患者是一名41岁的女性，她的脸上因长期偏头痛而注射了水罐植物提取物的病史，后来患了虹膜的双侧色素沉着。她没有任何前段葡萄膜炎或虹膜睫状体炎的迹象。她有一个同卵双胞胎姐妹，整个过程中虹膜色素沉着保持正常。结论土耳其的双侧急性脱色是文献中在土耳其患者中最近发现的一种情况（Tugal-Tutkun和Urgancioglu，Graefes Arch Clin Exp Ophthalmol 244：742-6，2006; Tugal-Tutkun等人，眼科116（8） ：1552-7，2009）。此病主要影响年轻女性，其特征是急性双侧基质色素沉着，无其他病理性眼部发现。这些患者通常保持正常视力，并且不会因在前房角收集色素而形成明显的青光眼。这种情况可能被误认为是Fuchs的异色虹膜睫状体炎，色素弥散综合症，假性剥脱综合征和病毒性虹膜睫状体炎。这是在北美首次报道的病例，对于与上述病理区别非常重要。我们的患者有面部注射猪笼草提取物的病史，但尚不清楚这是否与患者的BADI发育有关。随着对这种状况的认识的发展，可能的病因可能会被阐明。