Ligneous conjunctivitis associated with type I plasminogen deficiency: A rare case

Abstract

Ligneous conjunctivitis is a rare form of chronic, recurrent conjunctivitis characterized by wood-like, fibrinous pseudomembranes, which may be associated with systemic disease manifestations. It has been associated with congenital plasminogen (PLG) deficiency that is inherited with an autosomal recessive pattern due to mutations in the PLG gene and a variety of other genes, leading to disturbed wound healing. In this case report, we present the clinical, laboratory, and histopathological findings of a 36-year-old female patient who presented at the ophthalmology department with complaints of redness, irritation for the previous few weeks, and appearance of membranous lesions mainly on the tarsal conjunctivae. During biomicroscopic examination we found thick, yellowish-white pseudomembranes, and conjunctival proliferation with ligneous induration on the conjunctiva, located on the upper eyelids. Histopathological evaluations showed up ligneous conjunctivitis and laboratory evaluation confirmed a severe plasminogen deficiency (PLG < 2%). The patient was treated with topical fresh frozen plasma (FFP), topical steroids, heparin eye drops, and artificial tear drops daily, without systemic therapy.

Recurrent Meningitis and Its Rare Association With Ligneous Conjunctivitis and Congenital Plasminogen Deficiency

“…Currently, there is no widely accepted treatment protocol for ligneous conjunctivitis. However, topical plasminogen or heparin eye drops, topical or systemic fresh frozen plasma, and surgical excision of ligneous pseudomembranes were previously reported to be used as individual treatment modalities for ligneous conjunctivitis, most often with minor or sporadic success [ 14 ].…”

A case of IgG4-positive ligneous conjunctivitis mistaken for a conjunctival mass

“…LC is a disease with an estimated incidence of 16 cases per 1,000,000 people, and consanguineous marriage may be a predisposing factor for it [ 9 ]. It might be inherited in an autosomal-recessive manner, and its etiology might be related to local inflammation, plasminogen deficiency (type 1), plasminogen abnormality (type 2), tranexamic acid exposure, ocular insults such as trauma or infections and viral infection [ 10 – 12 ]. LC is a chronic disease, involving a wide range of age groups and prone to recurrence.…”