Ursea Roxana, De Castro Dawn, Bowen Trent J, Chan Chi-Chao
Department of Ophthalmology and Vision Science, College of Medicine, University of Arizona, Tucson, AZ 85711 USA.
Oculoplastics Service, Massachusetts Eye and Ear Infirmary, Boston, MA 02114 USA.
J Ophthalmic Inflamm Infect. 2015 Jan 23;5(1):1. doi: 10.1186/s12348-014-0033-9. eCollection 2015 Dec.
The purpose of this study is to describe a patient who was diagnosed with granulomatosis with polyangiitis based on conjunctival biopsy. This study is a case report and review of the literature.
A 48-year-old Caucasian woman presented with a 2-week history of a left eye peripheral corneal ulcer with adjacent conjunctivitis and a 4-month history of a non-resolving productive cough. Given her elevated serum perinuclear antineutrophil cytoplasmic antibody (P-ANCA) and erythrocyte sedimentation rate (ESR) levels as well as a chest computed topography (CT) that showed bilateral patchy infiltrates, suspicion of limited granulomatosis with polyangiitis with lung and ocular involvement was high. Because bronchoalveolar lavage was nondiagnostic for granulomatous disease, conjunctival biopsy was initially attempted in order to avoid a more invasive lung biopsy. The conjunctival biopsy revealed mixed subacute inflammatory mediators and vasculitis consistent with granulomatosis with polyangiitis.
Conjunctival biopsy may be a valuable, minimally invasive method for diagnosing systemic granulomatosis with polyangiitis.
本研究旨在描述一名经结膜活检确诊为肉芽肿性多血管炎的患者。本研究为病例报告及文献综述。
一名48岁的白种女性，有左眼周边角膜溃疡伴相邻结膜炎2周病史，以及持续4个月的非缓解性咳痰病史。鉴于其血清核周抗中性粒细胞胞浆抗体（P-ANCA）和红细胞沉降率（ESR）水平升高，以及胸部计算机断层扫描（CT）显示双侧斑片状浸润，高度怀疑为局限性肉芽肿性多血管炎伴肺部和眼部受累。由于支气管肺泡灌洗对肉芽肿性疾病无诊断价值，最初尝试进行结膜活检以避免更具侵入性的肺活检。结膜活检显示混合性亚急性炎症介质和血管炎，符合肉芽肿性多血管炎。
结膜活检可能是诊断系统性肉芽肿性多血管炎的一种有价值的、微创方法。
