Scleritis associated with sarcoidosis

Dursun, Dilek; Akova, Yonca A.; Bilezikçi, Banu

doi:10.1080/09273940490895353

Cited by 17 publications

(6 citation statements)

References 13 publications

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“…Sarcoidosis-associated scleritis may present as anterior diffuse, 47 anterior nodular, 47-49 or posterior scleritis. 50 All of the reported cases were women with ages ranging from 53 to 64 years old 47-49 which were on average older than most patients with sarcoid uveitis, except one patient (42-year-old man) with posterior scleritis who also had annular ciliochoroidal effusion. 50 Sarcoidosis-associated scleritis is more likely non-necrotizing, and tends to respond well to oral corticosteroids.…”

Section: Clinical Manifestations Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

215

185

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Sarcoidosis is one of the leading causes of inflammatory eye disease. Ocular sarcoidosis can involve any part of the eye and its adnexal tissues, and may cause uveitis, episcleritis/scleritis, eyelid abnormalities, conjunctival granuloma, optic neuropathy, lacrimal gland enlargement and orbital inflammation. Glaucoma and cataract can be complications from inflammation itself or adverse effects from therapy. Ophthalmic manifestations can be isolated, or associated with other organ involvement. Patients with ocular sarcoidosis can present with a wide range of clinical presentations and severity. Multi-disciplinary approaches are required to achieve the best treatment outcomes for both ocular and systemic manifestations.

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Section: Clinical Manifestations Of Ocular Sarcoidosismentioning

confidence: 99%

Ocular Sarcoidosis

Pasadhika

Rosenbaum

2015

Clinics in Chest Medicine

215

185

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“…The most commonly associated rheumatic diseases are RA (18-33%); systemic vasculitis (7-19%), of which Wegener's granulomatosis is the most common; systemic lupus erythematosus (SLE)(4-7%); inflammatory bowel disease (4-7%), and relapsing polychondritis (3%) [3,17]. Less commonly associated conditions include sarcoidosis [19,20], cryoglobulinemia [21], and hypocomplementemic urticarial vasculitis [22]. The most commonly associated infection is herpes zoster [18].…”

Section: Systemic Conditions Associated With Scleritismentioning

confidence: 99%

Scleritis and Peripheral Ulcerative Keratitis

Galor

Thorne

2007

Rheumatic Disease Clinics of North America

144

138

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Scleritis and peripheral ulcerative keratitis (PUK) can present as isolated conditions or as part of a systemic inflammatory or infectious disorder. Both are serious ocular conditions that can result in vision loss and therefore require early diagnosis and treatment. Nearly two-thirds of patients with non-infectious scleritis require systemic glucocorticoid therapy, and one fourth need a glucocorticoid-sparing agent, as well. Essentially all patients with non-infectious PUK require systemic glucocorticoids. Detailed clinical history, thorough physical examination, and thoughtful laboratory evaluations are all important in the exclusion of underlying disorders and extraocular involvement. KeywordsScleritis; peripheral ulcerative keratitis; glucocorticoids; cyclophosphamide; vasculitis; rheumatoid arthritis Scleritis and peripheral ulcerative keratitis (PUK) are two ocular disorders that require urgent attention for the purpose of diagnosis, treatment, and detection of underlying systemic inflammatory diseases.

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“…Anterior scleritis is an unusual ophthalmologic finding in sarcoidosis, and it has been related with Löf-gren's syndrome in a few cases [2]. Sporadic case reports [3] describe a good response to corticosteroids, but in this case, the scleritis responded well to non-steroidal antiinflamatory medication. The treatment of sarcoidosis with corticosteroids is not recommended [4] for stage II pulmonary sarcoidosis because 50 % of the untreated patients heal spontaneously.…”

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confidence: 74%

Sarcoidosis with complications

et al. 2014

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A 40-year-old man of Pakistani origin presented with a 2-week history of fever (39.5 8C), malaise and arthralgias. He had been living in Spain for 16 years, and he had not travelled to a foreign country in the prior 4 years. Three days before, conjunctival erythema and multiple painful and violaceous-erythematous nodules (red arrows in Panel B) appeared in both pretibial regions, preventing him from walking because of pain. Physical examination showed bilateral metacarpophalangeal, wrist, knee and ankle arthritis. Ophthalmologic examination showed bilateral anterior scleritis, with preserved visual acuity and without signs of uveitis (Panel A). A chest X-ray study demonstrated bilateral hilar and mediastinal adenopathies (blue arrows in Panel C). He was admitted to the internal medicine ward. Serum angiotensin conversor enzyme levels were normal. Human immunodeficiency virus serologies, Mantoux test, three sputum cultures with Ziehl-Neelsen staining and a bronchoalveolar lavage (BAL) ruled out infectious disease. The CD4/CD8 ratio in the BAL was 2:1. A transbronchial biopsy of an adenopathy showed nonnecrotizing granulomas, without microbiological findings. The patient was diagnosed as a case of sarcoidosis, with the clinical presentation of a Löfgren's syndrome. Lung alterations corresponded to a stage II pulmonary sarcoidosis. The patient was treated with dexamethasone eye drops and oral dexketoprofen. Scleritis, temperature, joint swelling and arthralgias disappeared, and he was discharged home. Two weeks later, he again developed fever and mild dyspnoea. Lung functional tests were normal, with the exception of a slightly lowered carbon monoxide lung diffusion (71 %), which was normalized after volume correction. After ruling out etiologies different from sarcoidosis, oral prednisone 20 mg/day was administered for a 4-week course as indicated in refractory disease, with total disappearance of symptomology. Adenopathies and parenchymal lung alterations remained stable. Currently, he has completed the treatment, and remains asymptomatic.We have presented a case of sarcoidosis with a typical Löfgren's syndrome, consisting of hilar adenopathies, erythema nodosum and polyarthralgia or polyarthritis. This syndrome is found more frequently in women, and the course is usually benign often with [1] spontaneous remission. Anterior scleritis is an unusual ophthalmologic finding in sarcoidosis, and it has been related with Löf-gren's syndrome in a few cases [2]. Sporadic case reports [3] describe a good response to corticosteroids, but in this case, the scleritis responded well to non-steroidal antiinflamatory medication. The treatment of sarcoidosis with corticosteroids is not recommended [4] for stage II pulmonary sarcoidosis because 50 % of the untreated patients heal spontaneously. Nevertheless, symptomatic Electronic supplementary material The online version of this article

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Scleritis associated with sarcoidosis

Abstract: Scleritis associated with sarcoidosis has rarely been described and it may be the presenting sign of systemic sarcoidosis.

Cited by 17 publications

References 13 publications

Ocular Sarcoidosis

Ocular Sarcoidosis

Scleritis and Peripheral Ulcerative Keratitis

Sarcoidosis with complications

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