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Orazbekov L, Issergepova B, Assainova M, Ruslanuly K. Granulomatosis with Polyangiitis with Ocular Manifestations. Case Rep Ophthalmol 2021; 12:98-104. [PMID: 33976664 PMCID: PMC8077634 DOI: 10.1159/000510959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/18/2020] [Indexed: 12/03/2022] Open
Abstract
Granulomatosis with polyangiitis (GPA) is a granulomatous-necrotic systemic vasculitis with a lesion of predominantly the upper and lower respiratory tracts at the onset of the disease (vasculitis, accompanied by granulomatous inflammation), and subsequently renal (glomerulonephritis). In addition, GPA may manifest as inflammation of small arteries and veins. Despite many years of study of this disease, the etiology of GPA remains unknown. The present case is about a 47-year-old female, who had been suffering from necrotizing scleritis, corneal ulcer, and secondary glaucoma in both eyes for 3 months, and she was treated with anti-inflammatory and antimicrobial therapy that showed no effect; the patient's general condition became worse. In the second week of treatment, multiple abscess ruptures exposed the sclera. Sampling of the affected conjunctival tissue and positive HLA B8 haplotype and ANCA (PR3-ANCA) testings make it clear that GPA was the main reason of necrotizing scleritis with inflammation. The targeted treatment of the underlying disease allows to stabilize an inflammation of corneal and scleral lesions.
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Affiliation(s)
- Lukpan Orazbekov
- First Ophthalmology Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Botagoz Issergepova
- Postgraduate Education Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Makpal Assainova
- Fourth Ophthalmology Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Kairat Ruslanuly
- Postgraduate Education Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
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Pérez-Jacoiste Asín MA, Charles P, Rothschild PR, Terrier B, Brézin A, Mouthon L, Guillevin L, Puéchal X. Ocular involvement in granulomatosis with polyangiitis: A single-center cohort study on 63 patients. Autoimmun Rev 2019; 18:493-500. [DOI: 10.1016/j.autrev.2019.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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3
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Hachicha F, Brour J, Zahaf A, Ben Abdallah M, Ouederni M, Cheour M, Kraiem A. [Progression of a rare and serious ocular manifestation of Wegener's granulomatosis: occlusive retinal vasculitis]. J Fr Ophtalmol 2014; 37:e153-5. [PMID: 25455551 DOI: 10.1016/j.jfo.2014.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/10/2014] [Accepted: 03/20/2014] [Indexed: 10/24/2022]
Affiliation(s)
- F Hachicha
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie.
| | - J Brour
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
| | - A Zahaf
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
| | - M Ben Abdallah
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
| | - M Ouederni
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie
| | - M Cheour
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
| | - A Kraiem
- Service d'ophtalmologie, hôpital Habib Thameur, rue de Bab el falah, 2004 Tunis, Tunisie; Faculté de médecine de Tunis, université Tunis El Manar, Tunis, Tunisie
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Barbosa-Cobos RE, Recillas-Gispert C, Arellanes-García L. [Ocular manifestations of primary systemic vasculitis]. REUMATOLOGIA CLINICA 2011; 7 Suppl 3:S12-7. [PMID: 22119276 DOI: 10.1016/j.reuma.2011.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 10/05/2011] [Indexed: 10/15/2022]
Abstract
A variety of ophthalmic manifestations can occur in patients who have systemic vasculitides and may be the presenting feature. Ocular involvement is frequently found and can result in significant morbidity, even in blindness. Early diagnosis and treatment may improve visual outcome. The management is challenging and requires a multidisciplinary approach. Treatment of ocular manifestations and systemic disease usually follows the same path. The mainstay of treatment is the use of systemic corticosteroids, usually combined with steroid-sparing immunosuppressive drugs. New, promising, emerging therapies rely on the development of biologic agents, which seem useful in the ocular manifestations of systemic vasculitides.
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Affiliation(s)
- Rosa Elda Barbosa-Cobos
- Servicio de Reumatología, Hospital Juárez de México, Col. Magdalena de Salinas, Delegación GA Madero, México DF, México
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Voss E, Raab P, Trebst C, Stangel M. Clinical approach to optic neuritis: pitfalls, red flags and differential diagnosis. Ther Adv Neurol Disord 2011; 4:123-34. [PMID: 21694809 DOI: 10.1177/1756285611398702] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Demyelinating optic neuritis (ON) is the most common cause of optic neuropathy typically presenting with a subacute painful visual loss. In 20% of patients with multiple sclerosis (MS), ON is the presenting symptom and half of the patients with isolated ON develop MS within 15 years. The diagnosis of ON plays an important role in neurological practice. A correct and early diagnosis is necessary to ensure optimal further investigations and treatment. Other causes of optic neuropathies such as connective tissue disorders, infectious diseases, tumours or ischaemic neuropathies are less frequent but clinical and therapeutic management can differ dramatically. We present five patients admitted to our hospital with suspected demyelinating ON, but the clinical work up revealed different causes of optic neuropathy. We discuss the differential diagnosis of ON and clinical red flags that require careful diagnostic assessment of other diseases. A workflow for the diagnosis of optic neuropathies is presented.
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Affiliation(s)
- Elke Voss
- Hannover Medical School, Hannover, Germany
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Pablo Sabat O, Víctor Velásquez R. Úvea y enfermedades sistémicas. REVISTA MÉDICA CLÍNICA LAS CONDES 2010. [DOI: 10.1016/s0716-8640(10)70616-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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7
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Current world literature. Curr Opin Ophthalmol 2010; 21:495-501. [PMID: 20948381 DOI: 10.1097/icu.0b013e3283402a34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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