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Panfili FM, Valente P, Ficari A, Cortellessa F, Vecchio D, Gonfiantini MV, Buonuomo PS, Colafati GS, Agolini E, Bartuli M, Modugno AC, Macchiaiolo M. Long-term follow-up in a pediatric patient with Ligneous Conjunctivitis due to PLG gene mutation in topical plasminogen treatment after successful use of ocular prosthesis for aesthetic rehabilitation: a case report. Ital J Pediatr 2023; 49:101. [PMID: 37612758 PMCID: PMC10463973 DOI: 10.1186/s13052-023-01503-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Ligneous Conjunctivitis (LC) is the most common clinical manifestation of Type I Plasminogen deficiency (T1PD; OMIM# 217090), and it is characterized by the formation of pseudomembranes (due to deposition of fibrin) on the conjunctivae leading to progressive vision loss. In past times, patients with LC were treated with surgery, topical anti-inflammatory, cytostatic agents, and systemic immunosuppressive drugs with limited results (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022, Surv Ophthalmol 48:369-388, 2003, Blood 131:1301-1310, 2018). The surgery can also trigger the development of membranes, as observed in patients needing ocular prosthesis (Surv Ophthalmol 48:369-388, 2003). Treatment with topical purified plasminogen is used to prevent pseudomembranes formation (Blood 108:3021-3026, 2006, Ophthalmology 129:955-957, 2022). CASE PRESENTATION We present the case of a sixteen-year-old girl with LC with severe left eye involvement. We reported the clinical conditions of the patient before and after the use of topical plasminogen eye drops and described the treatment schedule allowing the surgical procedure for the pseudomembranes debulking and the subsequent use of ocular prosthesis for aesthetic rehabilitation. CONCLUSIONS The patient showed a progressive response to the topical plasminogen, with a complete absence of pseudomembrane formation at a twelve-year follow-up, despite using an ocular prosthesis.
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Affiliation(s)
- Filippo Maria Panfili
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy
| | - Paola Valente
- Ophthalmology Department, Bambino Gesù Children's Hospital, IRCCS Pediatric Hospital, Rome, Italy
| | - Andrea Ficari
- Academic Department of Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabiana Cortellessa
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy
| | - Davide Vecchio
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy
| | - Michaela Veronika Gonfiantini
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy
| | - Paola Sabrina Buonuomo
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy
| | | | - Emanuele Agolini
- Laboratory of Medical Genetics Translational Cytogenomics Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | | | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children's Hospital, IRCCS, Pediatric Department, Piazza Di Sant'Onofrio, 4, 00165, Rome, Italy.
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