Vernal keratoconjunctivitis in Down syndrome: a case report

Abstract

Background Down syndrome (DS) or Trisomy 21 is the most common chromosomal disease and is characterized by possible heart defects, cognitive impairment and visual disorders. Case presentation We describe for the first time a 17-year-old Caucasian girl suffering from Down syndrome associated with vernal keratoconjunctivitis (VKC), a rare disorder of the anterior segment of the eye, characterized by intense photophobia, redness, watering eyes and itching due to an inflammatory-allergic reaction of the cornea and conjunctiva. On slit-lamp examination, the girl showed conjunctival hyperemia, papillary hypertrophy, giant papillae and corneal leukoma in right eye as a result of a previous corneal ulcer. A successful topical immunosuppressant therapy with cyclosporin 1% was started. Conclusion So far, to our knowledge, this is the first description of VKC in a patient with DS. Finding an inflammatory-allergic disease such as VKC in DS is unusual but it must be taken into account because keratoconus, one of the most frequent eye pathologies in DS, can be secondary to an unrecognized VKC.

Vernal Keratoconjunctivitis: A Systematic Review

“…of VKC patients Age Outcome Results JBI checklist Alharbi Edward [ 93 ] 2020 Saudi Arabia 1 29 To report a case of VKC with Rosai-Dorfman disease The association of RDD with VKC has not been previously reported; however, the causal relationship remains unclear High Bajracharya et al [ 94 ] 2020 Nepal 1 19 To report a case of sensory exotropia due to pellucid marginal degeneration (PMD) in association with VKC A child with VKC should undergo regular refraction so as not to miss any ectatic changes occurring in the cornea High Farias et al [ 95 ] 2021 Brazil 1 8 To describe an 8-year-old boy unsuccessfully treated for years for VKC Only after antiretroviral treatment, the allergy symptoms completely regressed. Consider investigation of HIV infection in patients with refractory allergic conjunctivitis High Fukushima Tabuchi [ 96 ] 2022 Japan 1 11 To describe a case of VKC associated with concomitant growth hormone deficiency (GHD) When treating VKC patients, it is important to bear the likelihood of GHD in mind, because of the possible correlation with VKC signs and symptoms Medium Artesani et al [ 97 ] 2023 Italy 1 17 To describe a case of VKC associated with down syndrome (DS) Finding an inflammatory/allergic disease such as VKC in DS is unusual, but it must be taken into account because keratoconus, one of the most frequent eye pathologies in DS, can be secondary to an unrecognized VKC …”