A case of scleritis associated rheumatoid arthritis accompanying an intraocular elevated lesion

Kobayashi, Takatoshi; Takai, Nanae; Tada, Rei; Shoda, Hiromi; Ikeda, Tsunehiko; Ozaki, Takurou; Makino, Shigeki

doi:10.1186/s12886-018-0797-z

Cited by 3 publications

(5 citation statements)

References 13 publications

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“…Although neuropsychological damage is not usually associated with RA, recent studies have suggested the possibility of developing cognitive impairment, responsible for the alteration of daily life in patients with RA [ 58 ]. Cognitive function includes many neuropsychological domains, dealing with orientation, attention, concentration, judgment, problem-solving, memory, and visual-spatial conception [ 59 ].…”

Section: Extra-articular Manifestations In Rheumatoid Arthritismentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

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Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease that affects about 1% of the global population, with a female–male ratio of 3:1. RA preferably affects the joints, with consequent joint swelling and deformities followed by ankylosis. However, evidence has accumulated showing that patients suffering from RA can also develop extra-articular manifestations, including cardiovascular disease states, neuropathies, and multiorgan dysfunction. In particular, peripheral nerve disorders showed a consistent impact in the course of the disease (prevalence about 20%) mostly associated to vasculitis of the nerve vessels leading to vascular ischemia, axonal degeneration, and neuronal demyelination. The pathophysiological basis of this RA-associated microvascular disease, which leads to impairment of assonal functionality, is still to be better clarified. However, endothelial dysfunction and alterations of the so-called brain-nerve barrier (BNB) seem to play a fundamental role. This review aims to assess the potential mechanisms underlying the impairment of endothelial cell functionality in the development of RA and to identify the role of dysfunctional endothelium as a causative mechanism of extra-articular manifestation of RA. On the other hand, the potential impact of lifestyle and nutritional interventions targeting the maintenance of endothelial cell integrity in patients with RA will be discussed as a potential option when approaching therapeutic solutions in the course of the disease.

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Section: Extra-articular Manifestations In Rheumatoid Arthritismentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

et al. 2021

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“…In a previously done clinical survey, it has also been observed that these patients may present early but their diagnosis is often delayed up to seven months thus affecting the prognosis of the disease. 4 In our case, there was not a single day's delay from the beginning which is what made our patient regain his vision in just a few months' time.…”

Section: Discussionmentioning

confidence: 52%

“…6 Ocular pain is the most common symptom, reported in 64% of patients with posterior scleritis, alerting the physician regarding an inflammatory condition. 4 B-scan ultrasonography is an important tool in diagnosis that may show scleral nodular thickening and diffuse hyper echogenicity, unlike choroidal neoplasms where there can be moderate hyper echogenicity or a hypoechogenicity. 3,7 We report an atypical presentation of posterior scleritis and choroiditis in a young man who came with a two-week history of a sudden decrease in right eye vision, redness, and moderate ocular pain.…”

Section: Discussionmentioning

confidence: 99%

“…Both posterior scleritis and orbital inflammatory syndrome present with similar orbital signs and respond well to steroids thus making it difficult to distinguish between them. 3,4 We report an unusual presentation of nodular posterior scleritis and choroiditis in a young man, who was initially diagnosed and investigated as a choroidal mass.…”

Section: Introductionmentioning

confidence: 99%

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Nodular posterior scleritis with associated choroiditis masquerading as a choroidal tumour- A Case Report

Muhammad Amer Awan,

Mohsin,

Abdullah Ahmed

et al. 2023

J Pak Med Assoc

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We report a case of nodular posterior scleritis in a 25-year-old male who presented with a 14-day history of unilateral decline in vision, pain, and redness in his right eye. Slit lamp examination of the right eye revealed dilated episcleral vessels present nasally as well as a choroidal mass at the nasal periphery of the fundus, associated with choroidal oedema. Systemic evaluation and imaging of the choroidal mass were performed to rule out choroidal tuberculoma and choroidal metastasis. Ultrasound B-scan of the right eye showed marked thickening of the nasal sclera resulting in sympathetic choroidal oedema without the characteristic T-sign. Nodular posterior scleritis with associated choroiditis, was diagnosed without any underlying systemic illness. The patient was immediately started on systemic steroids and later on subcutaneous Methotrexate as advised by the rheumatologist, to which he responded well and his vision significantly improved from 6/60 to 6/9, gradually during his treatment course.

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“…Scleritis, for example, when associated with RA, can lead to severe ocular complications and is thought to be caused by the deposition of the immune complex found in the necrotizing collagen associated with the sclera [53]. Most cases of scleritis are treated with immunosuppressive drugs and have a good resolution, although some refractory cases are more aggressive and resistant to steroid therapies [54].…”

Section: Extra-articular Manifestations In Rheumatoid Arthritis: Neurological Involvementmentioning

confidence: 99%

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Maiuolo¹,

Muscoli²,

Gliozzi³

et al. 2020

Preprint

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Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease that affects about 1% of the global population, with a female-male ratio of 3:1. To date, genetic predisposition, the involvement of a deficient immune system and lifestyle are known to be the major responsible for the onset of the disease. RA preferably affects the joints, with consequent joint swelling and deformities followed by ankylosis. Patients suffering from rheumatoid arthritis can also develop extra-articular manifestations, which mainly affect the cardiovascular system, the nervous system, the skin, the eye, the respiratory system, the kidney and the gastrointestinal system. It has been shown that about 20% of RA patients can develop neuropathies, multiple mononeuritis, distal sensory neuropathies and sense motor neuropathies. Neurological involvement occurs as a consequence of vasculitis of the nerve vessels leading to vascular ischaemia, axonal degeneration and neuronal demyelination. In RA, the risk of developing cardiovascular disease is very high and depends, most probably, on vascular damage resulting from endothelial dysfunction. Hence, it is reasonable to assume that the integrity of the endothelium is also involved in the neurological disorders resulting from RA. This review aims to highlight the main characteristics of the extra-articular manifestations at the nervous level resulting from rheumatoid arthritis. To this end, the literature main results on these pathological manifestations have been collected with particular focus on the involvement of endothelial dysfunction. In fact, the endothelium could be considered a valuable target for minimizing the incidence of extra-articular neurological manifestations in RA.

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A case of scleritis associated rheumatoid arthritis accompanying an intraocular elevated lesion

Cited by 3 publications

References 13 publications

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

Nodular posterior scleritis with associated choroiditis masquerading as a choroidal tumour- A Case Report

Endothelial Dysfunction and Extra-Articular Neurological Manifestations in Rheumatoid Arthritis

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