Successful infliximab treatment of posterior scleritis in a 13-year-old child refractory to other immunosuppressive therapy.
BACKGROUND
Posterior scleritis is a potentially blinding inflammatory disorder rarely seen in children. Standard care consists of systemic administration of steroids and immunosuppressants such as methotrexate or ciclosporin A. We describe the case of a young girl suffering from therapy refractory posterior scleritis successfully treated with the tumor necrosis factor (TNF) inhibitor infliximab.


METHODS
This study was an interventional case report. The medical chart of a 13-year-old child treated with infliximab (5 mg/kg, 10 applications at a 4-8 week interval) was reviewed for changes of visual acuity, fundoscopy, optic choherence tomography, ultrasound imaging, and adverse events.


RESULTS
Infliximab therapy (5 mg/kg, 10 applications at a 4-8 week interval) led to a long-term remission of posterior scleritis after unsuccessful therapy with high dose prednisolone, methotrexate, and ciclosporin A. To date no side effects have been reported.


CONCLUSIONS
Administration of infliximab may be considered under appropriate circumstances to treat children with posterior scleritis.
Universitätsmedizin Charité, Campus Virchow Klinikum, Augenklinik, Augustenburger Platz 1, 13353 Berlin, Germany. weisskatrin@aon.at
K
K
Weiss
R
R
Rieger
R
R
Keitzer
U
U
Pleyer
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D015423:Scleritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014463:Ultrasonography; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab