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1例巩膜炎伴类风湿性关节炎合并眼内病变。

A case of scleritis associated rheumatoid arthritis accompanying an intraocular elevated lesion.

作者信息

Kobayashi Takatoshi, Takai Nanae, Tada Rei, Shoda Hiromi, Kida Teruyo, Ikeda Tsunehiko, Ozaki Takurou, Makino Shigeki

机构信息

Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.

Tada Eye Clinic, Ikeda City, Japan.

出版信息

BMC Ophthalmol. 2018 May 30;18(1):129. doi: 10.1186/s12886-018-0797-z.

DOI:10.1186/s12886-018-0797-z
PMID:29843653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5975435/
Abstract

BACKGROUND

Scleritis and/or uveitis sometimes accompanies patients who suffer from rheumatoid arthritis. However, few studies have reported scleritis and/or uveitis accompanying a fundus elevated lesion, such as an intraocular tumor. In this study, we report a case of rheumatoid uveitis associated with an intraocular elevated lesion.

CASE PRESENTATION

A 66-year-old female visited another eye clinic and was diagnosed as bilateral anterior uveitis, and was prescribed steroid eye drops for treatment. She had previously been diagnosed as rheumatoid arthritis at the age of 30 years. Due to vitreous opacity that appeared in her right eye, we increased the instillation of steroid eye drops and the amount of oral prednisolone. Although the inflammation had improved, anterior uveitis relapsed, and an intraocular whitish elevated lesion resembling an intraocular tumor at the superior nasal retina appeared. We speculated this lesion to be a granuloma complicated with rheumatoid arthritis. Thus, we increased the amount of prednisolone administration, and the lesion began to shrink and ultimately fully disappeared.

CONCLUSIONS

We strongly believe that our case's lesion was a subretinal granuloma related with rheumatoid arthritis, as it disappeared by increased corticosteroid treatment. Our findings show that we should consider rheumatoid arthritis in a differential diagnosis of such types of fundus elevated lesions.

摘要

背景

巩膜炎和/或葡萄膜炎有时会出现在类风湿性关节炎患者身上。然而,很少有研究报道巩膜炎和/或葡萄膜炎伴有眼底隆起病变,如眼内肿瘤。在本研究中,我们报告了一例与眼内隆起病变相关的类风湿性葡萄膜炎病例。

病例介绍

一名66岁女性前往另一家眼科诊所就诊,被诊断为双侧前葡萄膜炎,并被开具了类固醇眼药水进行治疗。她曾在30岁时被诊断为类风湿性关节炎。由于右眼出现玻璃体混浊,我们增加了类固醇眼药水的滴注量和口服泼尼松龙的剂量。尽管炎症有所改善,但前葡萄膜炎复发,并且在视网膜鼻上象限出现了一个类似眼内肿瘤的白色眼内隆起病变。我们推测这个病变是一个合并类风湿性关节炎的肉芽肿。因此,我们增加了泼尼松龙的给药量,病变开始缩小并最终完全消失。

结论

我们坚信我们病例中的病变是一个与类风湿性关节炎相关的视网膜下肉芽肿,因为它通过增加皮质类固醇治疗而消失。我们的研究结果表明,在对此类眼底隆起病变进行鉴别诊断时应考虑类风湿性关节炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/c512899e9a8c/12886_2018_797_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/ddaf4107aa83/12886_2018_797_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/9e3b22d16c4b/12886_2018_797_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/b357db5c09e1/12886_2018_797_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/6affbbf369a3/12886_2018_797_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/c512899e9a8c/12886_2018_797_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/ddaf4107aa83/12886_2018_797_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/9e3b22d16c4b/12886_2018_797_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/b357db5c09e1/12886_2018_797_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/6affbbf369a3/12886_2018_797_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/374b/5975435/c512899e9a8c/12886_2018_797_Fig5_HTML.jpg

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系统性红斑狼疮患者中模仿脉络膜肿瘤的结节性后巩膜炎:一例报告及文献综述
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