Peripheral ulcerative keratitis in association with sarcoidosis

Harthan, Jennifer; Reeder, Renee

doi:10.1016/j.clae.2013.07.013

Cited by 15 publications

(7 citation statements)

References 28 publications

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“…A multitude of laboratory tests were ordered to rule out underlying etiologies including infection, connective tissue disease, sarcoidosis, inflammatory bowel disease, and alpha-1 antitrypsin deficiency. 6 , 7 Laboratory panels included a complete blood count with differential, erythrocyte sedimentation rate, anti-neutrophil cytoplasmic antibody (ANCA), fluorescent treponemal antibody and venereal disease research lab tests (FTA/VDRL), rheumatoid factor (RF), anti-myeloperoxidase, anti Scl-70, anti-chromatin, anti-DNA, anti-ribonucleoprotein, and anti-Jo-1, which all were negative. The two positive results were the Sjogren’s anti-la antibody and anti-nuclear antibody which were mildly elevated.…”

Section: Discussionmentioning

confidence: 99%

MALT Lymphoma Presenting with Peripheral Ulcerative Keratitis

Patil

Colby

Lazzaro

2022

IMCRJ

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Objective To report a case of ocular mucosa-associated lymphoid tissue (MALT) lymphoma presenting with peripheral ulcerative keratitis. Methods A 58-year-old man with a history of vitreous syneresis in both eyes and glaucoma presented with an abnormal, painful sensation of the left eye and mild hyperemia. Physical examination revealed peripheral ulcerative keratitis superiorly and a salmon-colored lesion in the superior conjunctiva. Results The differential diagnosis of superior corneal thinning includes collagen vascular disease, Terrien’s marginal degeneration, infectious keratitis, and other forms of peripheral keratitis. Our patient was diagnosed with conjunctival MALT lymphoma by surgical excision of the mass, and the peripheral ulcerative keratitis may be related to this diagnosis. Conclusion Although rare, this case demonstrates a peripheral keratitis possibly related to the underlying disease of MALT lymphoma. The patient is being treated with local radiation treatment.

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Section: Discussionmentioning

confidence: 99%

MALT Lymphoma Presenting with Peripheral Ulcerative Keratitis

Patil

Colby

Lazzaro

2022

IMCRJ

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“…The proximity to this vascular and lymphatic arch may explain the peripheral location of PUK as inflammatory cells and inflammation mediators can more easily access this part of the cornea. 26 , 27 …”

Section: Discussionmentioning

confidence: 99%

Baricitinib in severe and refractory peripheral ulcerative keratitis: a case report and literature review

Calvo-Río

Sánchez-Bilbao

Álvarez-Reguera

et al. 2022

Therapeutic Advances in Musculoskeletal

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Ocular disease, such as scleritis and peripheral ulcerative keratitis (PUK), may be a serious ocular complication. We present a patient with severe and refractory PUK treated with baricitinib. A review of the literature on Janus kinase inhibitors (JAKINIB) in refractory ocular surface pathology was also performed. For the literature review, the search in PubMed, Embase, and the Cochrane library was carried out from inception until 31 May 2021, including conference proceedings from four major rheumatology congresses. All original research articles studying JAKINIB treatment in patients with inflammatory eye disease were included. We present an 85-year-old woman with rheumatoid arthritis (RA) and secondary Sjögren’s syndrome refractory to methotrexate, leflunomide, certolizumab pegol, adalimumab, and tocilizumab (TCZ). However, 10 months after starting TCZ, the patient suffered a perforation secondary to PUK, requiring urgent surgical intervention. In the absence of infection, she was treated with boluses of intravenous methylprednisolone followed by oral prednisone at high doses in a decreasing pattern together with baricitinib at a dose of 2 mg/day with a very rapid and persistent favorable response to eye and joint symptoms. After 18 months of treatment, the patient had not presented serious side effects or signs of reactivation of her disease. In addition to this report, three other studies including one PUK associated with RA and two non-infectious scleritis treated with tofacitinib were included in this literature review. All three patients had experienced an insufficient response to conventional treatment, including biologic agents, before being switched to JAKINIB, leading to a complete or partial recovery in all of them without significant adverse effects so far. JAKINIBs (baricitinib and tofacitinib) may be an effective and safe therapy in patients with severe autoimmune and refractory ocular surface pathology, such as scleritis and PUK.

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“…Wegener granulomatosis, relapsing polychondritis, systemic lupus erythematosus, polyarteritis nodosa, Churg-Strauss syndrome, microscopic polyangiitis, psoriatic arthritis, Sjogren syndrome, and sarcoidosis have also been associated with PUK. 2,3,[22][23][24] Peripheral ulcerative keratitis normally occurs at the later stages of the disease in patients with rheumatoid arthritis, whereas it occurs at the earlier stages in patients with Wegener granulomatosis, commonly being the presenting sign. 22 Regardless of the time of presentation, the development of corneal ulceration in the setting of systemic autoimmune disease may represent progression of a potentially life-threatening disease and requires immunosupression.…”

Section: Corneal Manifestationsmentioning

confidence: 99%

Corneal Involvement in Systemic Inflammatory Diseases

Gomes

Santhiago

Jorge³

et al. 2015

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Corneal involvement in patients with systemic inflammatory disorders may be sight threatening, and it may be associated with a life-threatening disease. Significant systemic inflammatory diseases in this context are autoimmune connective tissue diseases, systemic autoimmune dermatological disorders, and autoimmune diseases of the lacrimal system. Keratoconjunctivitis sicca is usually the most common ocular finding in these patients. Peripheral ulcerative keratitis is a rare condition usually associated with increased ocular morbidity and also mortality, as it might act as an indicator of a more widespread vasculitis. Corneal biomechanical properties may also be altered in connective tissue diseases. Although recent studies suggest that the risk for corneal complications after ocular surgery in patients with quiescent autoimmune disease is minimal, caution is still recommended, as the knowledge about the corneal wound-healing process and the corneal biomechanical properties in these patients is not yet fully understood. This article reviews corneal abnormalities and characteristics in the setting of systemic inflammatory diseases.

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Peripheral ulcerative keratitis in association with sarcoidosis

Cited by 15 publications

References 28 publications

MALT Lymphoma Presenting with Peripheral Ulcerative Keratitis

MALT Lymphoma Presenting with Peripheral Ulcerative Keratitis

Baricitinib in severe and refractory peripheral ulcerative keratitis: a case report and literature review

Corneal Involvement in Systemic Inflammatory Diseases

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