Zandavalli Flávia Maria, de Castro Glaucio Ricardo Werner, Mazzucco Maiara, Stöfler Maria Eduarda Carvalho Wagnes, Pereira Ivânio Alves
Universidade do Sul de Santa Catarina, Florianópolis, SC, Brasil.
Universidade do Sul de Santa Catarina, Florianópolis, SC, Brasil.
Rev Bras Reumatol. 2015 May-Jun;55(3):310-2. doi: 10.1016/j.rbr.2014.05.006. Epub 2014 Oct 24.
Peripheral ulcerative keratitis is caused by an inflammatory and destructive process of the perilimbal peripheral cornea. This inflammation is due to immune complex deposition in this region of the cornea and in adjacent vessels. It can be idiopathic, or a manifestation of systemic disease such as rheumatoid arthritis, vasculitis of small vessels associated with ANCA, relapsing polychondritis, systemic lupus erythematosus and Crohn's disease. Its treatment includes the use of high-dose corticosteroids and, in some cases, the concomitant use of immunosuppressants such as methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide or cyclosporine. The use of immunobiological agents can be a strategy in cases of difficult control. The authors describe the treatment of three patients who, after failure with the use of corticosteroids or immunosuppressants, showed good response after the use of infliximab.
周边溃疡性角膜炎是由角膜缘周边角膜的炎症和破坏过程引起的。这种炎症是由于免疫复合物沉积在角膜的该区域和相邻血管中。它可以是特发性的，或者是全身性疾病的表现，如类风湿性关节炎、与抗中性粒细胞胞浆抗体相关的小血管血管炎、复发性多软骨炎、系统性红斑狼疮和克罗恩病。其治疗包括使用高剂量皮质类固醇，在某些情况下，还需同时使用免疫抑制剂，如甲氨蝶呤、硫唑嘌呤、霉酚酸酯、环磷酰胺或环孢素。在难以控制的情况下，使用免疫生物制剂可能是一种策略。作者描述了三名患者的治疗情况，他们在使用皮质类固醇或免疫抑制剂失败后，使用英夫利昔单抗后显示出良好的反应。
