Conjunctival ulceration in recurrent Wegener granulomatosis.
OBJECTIVE
To describe a patient with Wegener granulomatosis (WG) previously in remission who developed conjunctival ulceration as the first sign of disease recurrence.


METHODS
Case report and review of the literature.


RESULTS
Twenty-one years after WG was originally diagnosed and with the disease thought to be in remission, a 52-year-old man with complaints of ocular irritation for the previous year was found to have multiple palpebral conjunctival ulcerations of the left eye. Incisional biopsy revealed mixed inflammation consistent with WG. Within 3 months of recognition of his conjunctival ulcers, newly recurrent pulmonary inflammation developed and serologies for cytoplasmic-pattern antineutrophil cytoplasmic antibodies (C-ANCA) became positive.


CONCLUSIONS
Conjunctival ulceration is a rare manifestation of WG but may presage more widespread disease. Mucosal ulceration in a patient with a previous diagnosis of WG should stimulate an aggressive search for renewed systemic disease activity.
Department of Ophthalmology, Molecular Pathogenesis of Eye Infection Research Center, Dean A. McGee Eye Institute, University of Oklahoma Health Sciences Center, 608 Stanton L. Young Boulevard, Oklahoma City, OK, U.S.A.
Aaron C
AC
Fortney
James
J
Chodosh
D002908:Chronic Disease; D003229:Conjunctival Diseases / Q000209:etiology* / Q000473:pathology; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014456:Ulcer / Q000209:etiology* / Q000473:pathology