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Relapsing polychondritis with different types of ocular inflammations.

Furuya N, Oshitari T, Yotsukura J, Baba T, Yamamoto S - Int Med Case Rep J (2015)

Bottom Line: After tapering the prednisolone, the scleritis in both eyes improved.He was treated with intravenous antibiotics, and the left orbital cellulitis quickly improved.He was diagnosed with RP, and 40 mg/day oral prednisolone was given and his symptoms improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Chiba University, Graduate School of Medicine, Chuo-ku, Chiba, Japan.

ABSTRACT
We were presented with two cases of relapsing polychondritis (RP) associated with different types of ocular inflammation. The first case was a 35-year-old man who had bilateral hyperemic conjunctiva and ocular pain, and was referred to Chiba University Hospital with a diagnosis of episcleritis refractory. He was treated with dexamethasone eye drops. He developed tinnitus, deafness in both ears, and left auriculitis. A left auricular biopsy showed an infiltration of lymphocytes surrounding the cartilage. He was diagnosed with RP and treated with 30 mg/day oral prednisolone. After tapering the prednisolone, the scleritis in both eyes improved. The second case was a 71-year-old man who was deaf in both ears and had bilateral scleritis. At the first visit to our hospital, his left eyelid and right auricula were reddish and swollen, and he reported some pain. He was treated with intravenous antibiotics, and the left orbital cellulitis quickly improved. However, he developed right scleritis and left gonitis. Magnetic resonance imaging showed bilateral posterior scleritis and right auricular perichondritis. Auricular biopsy showed an infiltration of lymphocytes into the periauricular tissue. He was diagnosed with RP, and 40 mg/day oral prednisolone was given and his symptoms improved. Although RP is rare, it is a life-threatening disease. Thus, ophthalmologists should consider RP in patients with both ocular and auricular inflammation.

No MeSH data available.


Related in: MedlinePlus

Fundus photograph (upper) and fluorescein angiogram (lower) at the time of relapsing scleritis in Case 1.Note: Both optic discs are mildly hyperemic (upper) with slight hyperfluoresence in the fluorescein angiogram (lower).
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f2-imcrj-8-193: Fundus photograph (upper) and fluorescein angiogram (lower) at the time of relapsing scleritis in Case 1.Note: Both optic discs are mildly hyperemic (upper) with slight hyperfluoresence in the fluorescein angiogram (lower).

Mentions: In February 2009, visual field defects were detected bilaterally, namely, right enlargement of Mariotte blind spot and left mild central scotoma. Fundus examination showed mild hyperemic disks bilaterally (Figure 2). Fluorescein angiography revealed hyperfluorescence of both optic disks but vasculitis was not found (Figure 2). Magnetic resonance imaging findings were negative, thus eliminating optic neuritis.


Relapsing polychondritis with different types of ocular inflammations.

Furuya N, Oshitari T, Yotsukura J, Baba T, Yamamoto S - Int Med Case Rep J (2015)

Fundus photograph (upper) and fluorescein angiogram (lower) at the time of relapsing scleritis in Case 1.Note: Both optic discs are mildly hyperemic (upper) with slight hyperfluoresence in the fluorescein angiogram (lower).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581778&req=5

f2-imcrj-8-193: Fundus photograph (upper) and fluorescein angiogram (lower) at the time of relapsing scleritis in Case 1.Note: Both optic discs are mildly hyperemic (upper) with slight hyperfluoresence in the fluorescein angiogram (lower).
Mentions: In February 2009, visual field defects were detected bilaterally, namely, right enlargement of Mariotte blind spot and left mild central scotoma. Fundus examination showed mild hyperemic disks bilaterally (Figure 2). Fluorescein angiography revealed hyperfluorescence of both optic disks but vasculitis was not found (Figure 2). Magnetic resonance imaging findings were negative, thus eliminating optic neuritis.

Bottom Line: After tapering the prednisolone, the scleritis in both eyes improved.He was treated with intravenous antibiotics, and the left orbital cellulitis quickly improved.He was diagnosed with RP, and 40 mg/day oral prednisolone was given and his symptoms improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Chiba University, Graduate School of Medicine, Chuo-ku, Chiba, Japan.

ABSTRACT
We were presented with two cases of relapsing polychondritis (RP) associated with different types of ocular inflammation. The first case was a 35-year-old man who had bilateral hyperemic conjunctiva and ocular pain, and was referred to Chiba University Hospital with a diagnosis of episcleritis refractory. He was treated with dexamethasone eye drops. He developed tinnitus, deafness in both ears, and left auriculitis. A left auricular biopsy showed an infiltration of lymphocytes surrounding the cartilage. He was diagnosed with RP and treated with 30 mg/day oral prednisolone. After tapering the prednisolone, the scleritis in both eyes improved. The second case was a 71-year-old man who was deaf in both ears and had bilateral scleritis. At the first visit to our hospital, his left eyelid and right auricula were reddish and swollen, and he reported some pain. He was treated with intravenous antibiotics, and the left orbital cellulitis quickly improved. However, he developed right scleritis and left gonitis. Magnetic resonance imaging showed bilateral posterior scleritis and right auricular perichondritis. Auricular biopsy showed an infiltration of lymphocytes into the periauricular tissue. He was diagnosed with RP, and 40 mg/day oral prednisolone was given and his symptoms improved. Although RP is rare, it is a life-threatening disease. Thus, ophthalmologists should consider RP in patients with both ocular and auricular inflammation.

No MeSH data available.


Related in: MedlinePlus