Olsen K E, Holland E J
Department of Ophthalmology, University of Minnesota, Minneapolis 55455-0501, USA.
Cornea. 1998 Sep;17(5):504-7. doi: 10.1097/00003226-199809000-00007.
To assess the pathogenesis, symptomatology, and severity of rheumatoid arthritis (RA) in patient's with concomitant ocular cicatricial pemphigoid (OCP).
We retrospectively analyzed the charts of eight patients seen at a single institution between the years 1972 and 1997 with concomitant RA and OCP. Patients with OCP secondary to medical therapy, radiation, or chemical burns, or Stevens-Johnson syndrome were excluded.
The female-to-male ratio was 7:1. All patients had positive serum rheumatoid factors and immunohistochemical confirmation of OCP. The mean number of years of RA prior to OCP diagnosis was 19. The number of patients with stage II OCP was three of eight (37.5%). The number of patients with stage III OCP was five of eight (62.5%). All patients had radiologic evidence of degenerative joint disease and synovial thickening. All eight patients had keratoconjunctivitis sicca, five of eight patients (62.5%) had Sjögren's syndrome, and five of eight patients (62.5%) developed rheumatoid cornea necrosis leading to corneal perforation.
The implication exists that RA and OCP may be linked via an immunologically mediated mechanism and that patients with severe extraarticular symptoms associated with RA may be more likely to develop OCP. Prompt recognition of overlying symptoms may facilitate proper therapy for control of both diseases.
评估合并眼部瘢痕性类天疱疮（OCP）患者类风湿关节炎（RA）的发病机制、症状及严重程度。
我们回顾性分析了1972年至1997年间在单一机构就诊的8例合并RA和OCP患者的病历。排除继发于药物治疗、放射或化学烧伤或史蒂文斯-约翰逊综合征的OCP患者。
男女比例为7:1。所有患者血清类风湿因子均为阳性，且经免疫组化确诊为OCP。OCP诊断前RA的平均病程为19年。8例患者中II期OCP患者有3例（37.5%）。8例患者中III期OCP患者有5例（62.5%）。所有患者均有退行性关节病和滑膜增厚的影像学证据。所有8例患者均有干燥性角结膜炎，8例患者中有5例（62.5%）患有干燥综合征，8例患者中有5例（62.5%）发生类风湿性角膜坏死导致角膜穿孔。
RA和OCP可能通过免疫介导机制相关联，且伴有严重关节外症状的RA患者可能更易发生OCP。及时识别重叠症状可能有助于对两种疾病进行适当治疗以加以控制。
