Corneal melt secondary to eosinophilic granulomatosis with polyangiitis

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare antineutrophil cytoplasmic antibody-associated vasculitis that can affect any organ system. It is most often characterised by chronic airway inflammation along with prominent peripheral blood eosinophilia, although the disease can affect the cardiovascular, gastrointestinal, renal or central nervous systems. Ocular manifestations are uncommon and when they do occur, are varied in their clinical presentations. To the best of our knowledge, this is the first case of corneal melt secondary to EGPA to have been reported.

Spontaneous Corneal Perforation in Treatment-Resistant MPO-ANCA-Associated Small Vessel Vasculitis

“…To our knowledge, this is the first report of a corneal perforation resulting from sterile ulcerative keratitis possibly caused by MPO-ANCA-associated small vessel vasculitis, while there is one report of a corneal melt secondary to eosinophilic granulomatosis with polyangiitis and elevated MPO-ANCAs 4 . Although this patient was treated with both prednisolone as well as rituximab, a spontaneous corneal perforation occurred.…”

ANCA‐associated vasculitis with scleritis, corneal melt, and perforation rescued by rituximab: Case report and literature review

“…To analyze similar cases, PubMed, and Google Scholar were searched for the key words “ANCA‐associated vasculitis” and “corneal melt or corneal perforation”. Two patients with sufficient description 10,11 were found and summarized, together with the present case, in Table 1. Three patients are all men with the age at the initial visit ranging from 58 to 75 years.…”

“…Cataract surgery was successfully done to maintain ambulatory vision in one eye of this patient under the therapeutic control by intravenous rituximab. We also reviewed two additional similar cases in the literature who showed rapidly progressive corneal melt in ANCA‐associated vasculitis 10,11 …”

Peripheral ulcerative keratitis due to systemic diseases

“…Granulomatosis with polyangiitis [45,55] Polyarteritis nodosa [56] Microscopic polyangiitis [57] Eosinophilic granulomatosis with polyangiitis [58] Sarcoidosis [59--61] Behcet's disease [62] Takayasu arteritis Temporal arteritis [63,64] Leukocytoclastic vasculitis [65,66] Cryoglobulinemia [67] IgA vasculitis [57] Atypical HUS [68] Erythema elevatum diutinum [66,69] Systemic infections Herpes simplex virus (HSV) [70--72] Varicella zoster virus (VZV) [73,74] Tuberculosis (Tb) [75,76] Syphilis [77] Bartonella [78] Salmonella gastroenteritis [79] Acquired immune deficiency syndrome [ Hidradenitis suppurativa [93,94] Pityriasis rubra pilaris [95] Drug Induced Checkpoint inhibitors [96--98] Paraquat [99] Rituximab [100] Postvaccine [101] Perifosine [102] Immune reconstitution following antiretrovirals [103] Methamphetamine [104] Other autoimmune Antimyelin oligodendrocyte protein [105,106] IgG4 disease [107] Autoimmune hepatitis [108] Systemic onset juvenile idiopathic arthritis (JIA) [109] Chronic granulomatous disease [110] Local Insults: Microbial keratitis, including bacterial, fungal, viral, mycobacterial, and acanthamoeba Staphylococcal marginal keratitis Postsurgical…”