A Case of Nodular Scleritis in Association With Behcet`s Disease

Chang, Hyun Kyu; Cho, Eun Hee

doi:10.3904/kjim.2001.16.1.47

Cited by 14 publications

(6 citation statements)

References 12 publications

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“…In people, nodular episcleritis has been reported with Hodgkin’s lymphoma, 53 whereas scleritis has been reported to be associated with systemic inflammatory conditions such as rheumatoid arthritis, Wegener’s granulomatosis, relapsing polychondritis, and systemic lupus erythematosus 54 . Evidence of systemic disease was not observed in the patient described here; this is consistent with other reports in domestic animal species 16 …”

Section: Discussionsupporting

confidence: 90%

Surgical management of orbital nodular granulomatous episcleritis in a dog

Barnes

Pearce

Berent

et al. 2010

Veterinary Ophthalmology

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A 27 kg, 6-year-old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well-circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en-bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.

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Section: Discussionsupporting

confidence: 90%

Surgical management of orbital nodular granulomatous episcleritis in a dog

Barnes

Pearce

Berent

et al. 2010

Veterinary Ophthalmology

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“…Although the mechanism by which the inflammatory process in Behcet disease induces scleritis remains unclear, necrotizing scleritis and nodular scleritis secondary to Behcet disease have been reported. [7,8] Development or aggravation of scleritis has been reported to be associated with generalized vasculitis disease. [9] As vasculitis is the underlying pathology of Behcet disease, there is a possibility that scleritis develops as a complication of Behcet disease.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of Behcet disease with posterior scleritis

et al. 2019

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Rationale:Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet disease.Patient concerns:A 50-year-old man previously diagnosed with systemic Behcet disease presented with ocular pain and decreased vision in the left eye.Diagnosis:Posterior scleritis associated with Behcet disease was diagnosed based on optical coherence tomography showing choroidal folds, as well as contrast computed tomography and ultrasound sonography demonstrating thickening of the posterior sclera.Interventions:Treatment with systemic corticosteroids was initiated. Since inflammation relapsed during steroid tapering, anti-tumor necrosis factor-alpha (TNF-α) therapy was used in combination, and tapering of steroids was possible without recurrence of inflammation for 12 months.Outcomes:Posterior scleritis was resolved and visual acuity improved. With the continuation of TNF-α therapy, oral prednisolone was successfully tapered and discontinued. No relapse of inflammation was observed at follow-up 1 year after discontinuation of prednisolone.Lessons:Ophthalmologists should be aware of the possibility of rare manifestation of posterior scleritis in patients with Behcet disease, and that combined use of systemic steroids and anti-TNF-α therapy may resolve the scleritis without recurrence of inflammation.

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“…The eye involvement in BD group was mostly on the posterior uveal tract, and that in SpA group was totally on the anterior uveal tract. We experienced a 46-yr-old female with BD who developed a nodular scleritis (31).…”

Section: Discussionmentioning

confidence: 99%

The Comparison Between Behcet's Disease and Spondyloarthritides: Does Behcet's Disease Belong to the Spondyloarthropathy Complex?

et al. 2002

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This study was to clarify whether Beh et's disease (BD) could be classified into the spondyloarthropathy (SpA) complex. It was undertaken on 58 patients with BD (BD group), 56 patients with SpA (SpA group), and 3 patients who concurrently satisfied the criteria for BD and SpA (BDSpA group). The clinical parameters and known susceptible HLA antigens were compared between BD group and SpA group. In addition, 3 patients in BDSpA group were reviewed. The prevalence of definitive sacroiliitis (SI) in BD group and SpA group was 46.4% and 5.2%, respectively. However, none had a definitive SI in healthy controls. Enthesitis was observed in 3.4% of BD group and in 50% of SpA group. The patterns of eye involvement were different between these two groups. HLA-B27 was negative in all 49 patients of BD group, whereas it was positive in 67.9% of SpA group. The prevalence of HLA-B51 was 51.7% in BD group, and that in SpA group was 21.4%. One patient in BDSpA group was considered to have concurrent BD and ankylosing spondylitis (AS). Another patient was closer to AS, and the third to BD. Conclusively, it seems that BD could not be classified into the SpA complex.

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A Case of Nodular Scleritis in Association With Behcet`s Disease

Cited by 14 publications

References 12 publications

Surgical management of orbital nodular granulomatous episcleritis in a dog

Surgical management of orbital nodular granulomatous episcleritis in a dog

An unusual case of Behcet disease with posterior scleritis

The Comparison Between Behcet's Disease and Spondyloarthritides: Does Behcet's Disease Belong to the Spondyloarthropathy Complex?

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