Research Group in Neurosciences NeURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
Escuela Barraquer. Research Group, Escuela Superior de Oftalmología del Instituto Barraquer de América, Bogotá, Colombia.
Eur J Ophthalmol. 2022 Jul;32(4):NP52-NP55. doi: 10.1177/1120672121996637. Epub 2021 Feb 18.
To present a rare and novel association of Ocular Cicatricial Pemphigoid, Sjögren's Syndrome, and Hashimoto's Thyroiditis as a Multiple Autoimmune Syndrome.
A 43-year-old Colombian female, presented with corneal ulcers, associated with trichiasis. At the ophthalmological examination forniceal shortening OU and symblepharon OD was found. Conjunctival biopsy was performed, evidencing linear deposition of IgG and IgA antibodies along the basement membrane of the conjunctiva, confirming Ocular Cicatricial Pemphigoid diagnosis. After 12 years, the patient presented constitutional symptoms, xerostomia, and worsening of xerophthalmia. Laboratory tests showed positive Anti-TG, Anti-TPO, Anti-Ro, and Anti-La antibodies, and salivary gland biopsy was consistent with Sjögren's Syndrome. Due to these findings, Hashimoto's Thyroiditis and Sjögren's Syndrome were diagnosed, defining a Multiple Autoimmune Syndrome.
A novel association of Multiple Autoimmune Syndrome is presented in this case. Ophthalmologists and other specialists involved in the evaluation and treatment of patients with autoimmune diseases, should be aware of this clinical presentation. A multidisciplinary approach in this condition is important for optimum treatment instauration and follow-up, in order to prevent complications.
介绍一种眼瘢痕性类天疱疮、干燥综合征和桥本甲状腺炎的罕见新关联,即多发性自身免疫综合征。
一名 43 岁的哥伦比亚女性,出现角膜溃疡,伴有倒睫。眼部检查发现双眼穹隆缩短和睑球粘连。进行结膜活检,显示 IgG 和 IgA 抗体沿结膜基底膜线性沉积,确诊为眼瘢痕性类天疱疮。12 年后,患者出现全身症状、口干和眼干恶化。实验室检查显示抗 TG、抗 TPO、抗 Ro 和抗 La 抗体阳性,唾液腺活检符合干燥综合征。由于这些发现,诊断为桥本甲状腺炎和干燥综合征,确定为多发性自身免疫综合征。
本病例报告了一种多发性自身免疫综合征的新关联。眼科医生和其他参与自身免疫性疾病评估和治疗的专家应注意这种临床表现。在这种情况下,多学科方法对于最佳治疗的启动和随访非常重要,以预防并发症。