晚发高安动脉炎伴发后巩膜炎:病例报告。

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY
Yann Bertolani, Tetiana Goncharova, Eric Kirkegaard-Biosca, Julia Angrill-Valls, Natalia Anglada-Masferrer, Liliana Gutuleac, Laura Distefano, Miguel Ángel Zapata
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引用次数: 0

摘要

目的:描述一例罕见的后巩膜炎伴有晚发型高安动脉炎的病例:报告了一例 75 岁女性后巩膜炎病例,该病例最终被诊断为晚发性高安动脉炎。对患者进行了多次医疗评估,包括眼科和风湿科随访。进行了多项诊断检查,治疗的基础是皮质类固醇激素和 IL-6 抑制剂托西珠单抗:患者因右单侧眼睑水肿、化脓和红眼病被送入我院急诊室。此前,她曾有过两次眼睑水肿,但被误诊为眼睑前蜂窝组织炎。超声波检查发现脉络膜皱褶和 T 征,高度提示后巩膜炎。后来,患者被诊断为高安动脉炎,这是一种大血管炎。患者开始接受类固醇治疗,后来改用IL-6抑制剂,以更好地控制全身疾病:结论:后巩膜炎经常被误诊,临床上需要高度怀疑。多模式诊断对于确定准确诊断非常重要。多达 34% 的病例可能伴有全身性疾病。这是文献中描述的第一例后巩膜炎伴有晚发高安动脉炎的病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posterior Scleritis Associated with Late-Onset Takayasu Arteritis: A Case Report.

Purpose: To describe a rare case of posterior scleritis associated with late-onset Takayasu arteritis.

Methods: A case report of a 75-year-old female presenting with posterior scleritis, eventually diagnosed with late-onset Takayasu arteritis was described. Several medical evaluation visits were conducted, including ophthalmological and rheumatological follow-up. Multiple diagnostic tests were carried out, and the cornerstones of the treatment were corticosteroids and the IL-6 inhibitor tocilizumab.

Results: The patient was admitted to our hospital's emergency room with right unilateral eyelid edema, chemosis and red eye. She had previously experienced two episodes that were misdiagnosed as preseptal cellulitis. The presence of choroidal folds and the T sign on the ultrasound exam were highly suggestive of posterior scleritis. Later, the patient was diagnosed with Takayasu arteritis, a type of large vessel vasculitis. Treatment with steroids was started, which was later switched to IL-6 inhibitors to achieve better control of the systemic disease.

Conclusion: Posterior scleritis is often misdiagnosed, necessitating high clinical suspicion. Multimodal diagnosis is important to establish an accurate diagnosis. Up to 34% of cases may be associated with a systemic disease. This is the first case described in the literature of posterior scleritis associated with late-onset Takayasu arteritis.

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来源期刊
CiteScore
6.20
自引率
15.20%
发文量
285
审稿时长
6-12 weeks
期刊介绍: Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.
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