[Ocular presentation in Wegener granulomatosis].
METHODS
A 71 year-old female presented with bilateral conjunctivitis, scleritis and peripheral ulcerative keratitis. Ancillary tests showed presence of anti-neutrophil cytoplasmic antibodies, with diffuse granular cytoplasmic immunofluorescence staining (ANCAc). Conjunctival biopsy showed necrotizing vasculitis in small vessels. Diagnosis of Wegener Granulomatosis (WG) was established and upper respiratory affection detected. Treatment with megadoses of cyclophosphamide and corticoids was initiated and remission of the disease was obtained.


CONCLUSIONS
WG is a potentially lethal systemic vasculitis in which ocular involvement may be the first clinical presentation. Scleritis and peripheral ulcerative keratitis indicate systemic involvement, highlighting the importance of prompt diagnosis and treatment.
Torres
R M
RM
Unidad de Superfice e Immunología Ocular, Instituto Universitario de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain. rotor@ioba.med.uva.es
Herreras
J M
JM
Becerra
E
E
Blanco
G
G
Méndez
M C
MC
Saornil
M A
MA
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D001706:Biopsy; D003231:Conjunctivitis / Q000209:etiology* / Q000473:pathology; D003320:Corneal Ulcer / Q000209:etiology*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D015423:Scleritis / Q000209:etiology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone