Orbital myositis in systemic lupus erythematosus: A case report and literature review

Abstract

The aim of the European Journal of Rheumatology is to cover various aspects of rheumatology for its readers, encompassing the spectrum of diseases with arthritis, musculoskeletal conditions, autoinflammatory diseases, connective tissue disorders, osteoporosis, translational research, the latest therapies and treatment programs. European Journal of Rheumatology publishes original articles, invited reviews, case based reviews, letters to the editor and images in rheumatology. The publication language of the journal is English. Accepted manuscripts are copy-edited for grammar, punctuation, and format. Once the publication process of a manuscript is completed, it is published online on the journal's webpage as an aheadof-print publication before it is included in its scheduled issue. A PDF proof of the accepted manuscript is sent to the corresponding author and their publication approval is requested within 2 days of their receipt of the proof.

Refractory Orbital Myositis in Systemic Lupus Erythematosus - A Role for Rituximab

“…It is characterized by inflammation of the extraocular muscles with risk of developing amaurosis [2,4] . Clinical manifestations are similar in all reported casesunilateral or bilateral ocular pain, oedema, diplopia and limitation in extraocular movement [3] .…”

“…Orbital myositis in SLE is an entity rarely described in the literature. To our knowledge, only 7 cases have been reported [ 3 ] . It is characterized by inflammation of the extraocular muscles with risk of developing amaurosis [ 2 , 4 ] .…”

“…Although the risk of serious complications is low, progression to ocular ischaemia and subsequent amaurosis can occur. A biopsy for histological confirmation is essential, but it should not delay treatment [ 3 , 5 ] .…”

“…Diagnosis is challenging, as clinical manifestations are nonspecific and mimic other (more common) entities, which should be excluded. It is important to exclude infectious causes (orbital cellulitis usually presents with fever, elevation of inflammatory parameters, history of trauma or an extension of other head and neck infections), endocrinological causes (Graves' ophthalmopathy, easily ruled out with thyroid antibody testing and thyroid function tests), infiltrative (sarcoidosis) and neoplastic causes (for example, lymphoma, uveal melanoma) [3] . Orbital myositis is not a specific finding of SLE.…”

“…Although the risk of serious complications is low, progression to ocular ischaemia and subsequent amaurosis can occur. A biopsy for histological confirmation is essential, but it should not delay treatment [3,5] . High doses of systemic corticosteroid is the first choice for the treatment of orbital myositis leading usually to a quick clinical improvement, although recurrences have been documented [5] .…”