Orbital infarction and melting in a patient with systemic lupus erythematosus.
OBJECTIVE
To present a patient with systemic lupus erythematosus who developed infarction and melting of the orbit secondary to her systemic disease.


METHODS
A case report.


METHODS
A 61-year-old white woman with a 5-year history of systemic lupus erythematosus.


METHODS
The patient presented with left orbital pain, limitation of extraocular movements, and a fistula from the ethmoid sinus to the upper eyelid. A detailed examination with computerized tomography, ultrasound, and a comprehensive medical evaluation with laboratory testing was performed. Histopathologic analysis with special stains of the orbital tissues was also performed.


RESULTS
Histopathologic examination of the biopsy specimens revealed the features of an inflammatory process involving the orbit, similar to a panniculitis. These include a lymphocytic reaction with a predominance of plasma cells, vasculitis with occlusion, and thickening of the vessel walls, necrosis, and hyalinization of fat.


CONCLUSIONS
This is a unique case in which infarction and melting of the entire orbital structures occurred in the presence of systemic lupus erythematosus. The underlying disease process is a lupus-related panniculitis. The authors stress that this is a very rare entity and that other diseases should be ruled out before entertaining this diagnosis.
Arthurs
B P
BP
Department of Ophthalmology, McGill University Hospital Center, Montreal, Quebec, Canada.
Khalil
M K
MK
Chagnon
F
F
Lindley
S K
SK
Anderson
D P
DP
Burnier
M
M
D005128:Eye Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D009915:Orbit / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D010146:Pain / Q000209:etiology; D015435:Panniculitis, Lupus Erythematosus / Q000150:complications* / Q000473:pathology; D011859:Radiography