Hegab S M, al-Mutawa S A
Ophthalmology Department, Ibn Sina Hospital, Hawailli, Kuwait.
Ophthalmic Surg. 1994 Sep-Oct;25(9):638-9.
A 38-year-old woman with documented Crohn's disease (CD) had uniocular nodular episcleritis and a limbal nodule with surrounding infiltrate, which, when healed, left residual pannus. The episcleral nodule was abnormally large (7 x 5 x 3 mm). A localized conjunctival ulceration, a rare manifestation, to our knowledge not previously reported, developed later in the same eye. Impression cytology of the ulcer showed pyknotic conjunctival epithelium and absence of goblet cells, together with the presence of a few plasma cells, lymphocytes, and macrophages. These features are comparable to those seen in the intestinal mucosa of patients with CD. The unilaterality of the ocular infection together with the good response to local therapy suggests that a local antigen-antibody immune complex reaction was involved. We recommend local therapy as a first treatment option.
一名有克罗恩病（CD）记录的38岁女性出现单眼结节性巩膜炎和角膜缘结节伴周围浸润，愈合后留下残余血管翳。巩膜结节异常大（7×5×3毫米）。同一眼后来出现了局限性结膜溃疡，据我们所知，这是一种罕见的表现，此前未见报道。溃疡的印片细胞学检查显示结膜上皮固缩，杯状细胞缺失，同时存在少量浆细胞、淋巴细胞和巨噬细胞。这些特征与CD患者肠黏膜中所见的特征相似。眼部感染的单侧性以及对局部治疗的良好反应表明涉及局部抗原 - 抗体免疫复合物反应。我们建议将局部治疗作为首选治疗方案。
