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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

Ocular findings after scleritis.Notes: The conjunctiva of the right eye is hyperemic (upper left). Optical coherence tomographic image shows slight serous retinal detachment in the left eye (middle left). Magnetic resonance image shows high intensity signals (arrows) of both scleras (upper right). B-mode ultrasonography shows thickening of the sclera in both eyes (lower panels).Abbreviations: L, left; R, right.
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f5-imcrj-8-193: Ocular findings after scleritis.Notes: The conjunctiva of the right eye is hyperemic (upper left). Optical coherence tomographic image shows slight serous retinal detachment in the left eye (middle left). Magnetic resonance image shows high intensity signals (arrows) of both scleras (upper right). B-mode ultrasonography shows thickening of the sclera in both eyes (lower panels).Abbreviations: L, left; R, right.

Mentions: Computed tomography showed no sinusitis, but the fat density on the upper surface of the eye was increased (Figure 4). Blood tests revealed an elevation of white blood cells (11,100/µL), the erythrocyte sedimentation rate (69 mm/h), and the CRP to 8.7 mg/dL. He was diagnosed with left orbital cellulitis and treated with intravenous antibiotics. The left orbital cellulitis rapidly improved but he developed right scleritis and left gonitis (Figure 5). A second blood test showed an elevation of erythrocyte sedimentation rate and CRP and positive antinuclear antibodies. The anti-type II collagen antibody was negative. Topical antibiotics and steroids were started. Magnetic resonance imaging showed bilateral posterior scleritis and right auricular perichondritis (Figure 5). Because he had auricular perichondritis and cochleovestibular disorders on January 30, 2014, an auricular biopsy was performed. An infiltration of lymphocytes into the periauricular tissue was found histologically (Figure 6).


Relapsing polychondritis with different types of ocular inflammations.

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

Ocular findings after scleritis.Notes: The conjunctiva of the right eye is hyperemic (upper left). Optical coherence tomographic image shows slight serous retinal detachment in the left eye (middle left). Magnetic resonance image shows high intensity signals (arrows) of both scleras (upper right). B-mode ultrasonography shows thickening of the sclera in both eyes (lower panels).Abbreviations: L, left; R, right.
© Copyright Policy
Related In: Results  -  Collection

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

f5-imcrj-8-193: Ocular findings after scleritis.Notes: The conjunctiva of the right eye is hyperemic (upper left). Optical coherence tomographic image shows slight serous retinal detachment in the left eye (middle left). Magnetic resonance image shows high intensity signals (arrows) of both scleras (upper right). B-mode ultrasonography shows thickening of the sclera in both eyes (lower panels).Abbreviations: L, left; R, right.
Mentions: Computed tomography showed no sinusitis, but the fat density on the upper surface of the eye was increased (Figure 4). Blood tests revealed an elevation of white blood cells (11,100/µL), the erythrocyte sedimentation rate (69 mm/h), and the CRP to 8.7 mg/dL. He was diagnosed with left orbital cellulitis and treated with intravenous antibiotics. The left orbital cellulitis rapidly improved but he developed right scleritis and left gonitis (Figure 5). A second blood test showed an elevation of erythrocyte sedimentation rate and CRP and positive antinuclear antibodies. The anti-type II collagen antibody was negative. Topical antibiotics and steroids were started. Magnetic resonance imaging showed bilateral posterior scleritis and right auricular perichondritis (Figure 5). Because he had auricular perichondritis and cochleovestibular disorders on January 30, 2014, an auricular biopsy was performed. An infiltration of lymphocytes into the periauricular tissue was found histologically (Figure 6).

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