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泰格森浅层点状角膜炎(TSPK):一例儿科病例报告及文献复习。

Thygeson's superficial punctate keratitis (TSPK): a paediatric case report and review of the literature.

机构信息

Department of Ophthalmology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, 136, Zhongshan 2nd RD, Yuzhong District, 400014, Chongqing, China.

出版信息

BMC Ophthalmol. 2021 Jan 29;21(1):64. doi: 10.1186/s12886-020-01790-6.

Abstract

BACKGROUND

Thygeson's superficial punctate keratitis (TSPK) is reportedly a rare disease with an insidious onset, numerous remissions and exacerbations, and a long duration. The corneal lesions are elevated, whitish-grey in colour, and granular in the intraepithelium. A few reported cases of TSPK exist, and paediatric experience is limited. Due to the unknown aetiology and controversial treatment strategies for TSPK, we performed a literature review to summarize the criteria for the diagnosis, treatment and prognosis of TSPK to provide a basis for the treatment of TSPK in paediatric patients.

CASE PRESENTATION

The clinical course of a boy with TSPK who repeatedly presented with episodes of tearing, photophobia and foreign body sensation in both eyes is described. Irritation was uncontrollable with antiviral and antibiotic medications, and it was managed by corticosteroids. No recurrence was reported at the 1-year follow-up after corticosteroid replacement and tapering.

CONCLUSIONS

The clinical features, treatment and prognosis between adult and paediatric TSPK patients have many similarities. The diagnosis of TSPK in children is more difficult, leading to missed diagnosis. TSPK needs to be carefully differentiated from other types of keratitis, especially intraepithelial secondary and other infectious ocular surface diseases.

摘要

背景

据报道,泰格森浅层点状角膜炎(TSPK)是一种罕见疾病,具有隐匿性发病、多次缓解和加重以及病程长的特点。角膜病变呈隆起状,灰白色,上皮内呈颗粒状。有少数 TSPK 的报道病例,儿科经验有限。由于 TSPK 的病因不明和治疗策略存在争议,我们进行了文献回顾,总结了 TSPK 的诊断、治疗和预后标准,为儿科患者 TSPK 的治疗提供依据。

病例介绍

描述了一名患有 TSPK 的男孩的临床病程,他双眼反复出现流泪、畏光和异物感。抗病毒和抗生素药物无法控制刺激,因此使用皮质类固醇治疗。皮质类固醇替代和逐渐减量后 1 年随访时未报告复发。

结论

成人和儿科 TSPK 患者的临床特征、治疗和预后有许多相似之处。儿童 TSPK 的诊断较为困难,导致漏诊。TSPK 需要与其他类型的角膜炎,特别是上皮内继发和其他感染性眼表疾病仔细鉴别。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f355/7845125/78180e94be7b/12886_2020_1790_Fig1_HTML.jpg

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