Conjunctivitis as a manifestation of Wegener's Granulomatosis

To report a case of prolonged conjunctivitis as the manifestation of Granulomatosis with polyangiitis (GPA). A 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. He was taking medication for his conjunctivitis without any response. A slit-lamp examination reve...

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Bibliographic Details
Published in:Iranian journal of ophthalmology 2018-09, Vol.30 (3), p.268-272
Main Authors: Nejabat, Mahmoud, Mahmoudi Nezhad, Golnoush Sadat, Shenavandeh, Saeedeh, Ashraf, Mohammad Javad, Jalalpour, Mohammad Hassan
Format: Article
Language:English
Subjects:
Arthritis
Cataracts
Edema
Emergency medical care
Fistula
Granulomatosis with polyangiitis
Inflammatory diseases
Keratitis
Medical imaging
Pain
Patients
Prolonged conjunctivitis
Scleritis
Sinuses
Systemic diseases
Thrombosis
Vein & artery diseases
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Summary:To report a case of prolonged conjunctivitis as the manifestation of Granulomatosis with polyangiitis (GPA). A 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. He was taking medication for his conjunctivitis without any response. A slit-lamp examination revealed conjunctivitis and scleritis in the right eye. Conjunctivitis, 360-degree peripheral corneal thinning, corneal perforation, and scleritis were seen in the left eye. Emergency penetrating keratoplasty was performed to treat the patient's corneal perforation. After a consultation with the Internal Medicine Department, the patient was suspected of having GPA with positive cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA). Functional endoscopic sinus surgery was performed to treat right maxillary sinusitis, and a biopsy of the maxillary sinus mucosa was obtained. The pathology report showed granuloma and vasculitis with severe acute and chronic inflammation and few eosinophils; thus, the diagnosis was confirmed. Because prolonged conjunctivitis occurs only rarely in association with systemic disease, ophthalmologists should be aware of this potential, particularly in patients with GPA.
ISSN:2452-2325
2452-2325
DOI:10.1016/j.joco.2017.11.003