A complex orbit.
Wegener's Granulomatosis (WG) in its limited form can be a challenging diagnosis. ANCA, radiological investigations and histology should be interpreted in light of clinical findings. A delay in diagnosis can have profound visual consequences. Immunosuppressive therapy and co-morbidities can mask signs of orbital sepsis. A low threshold for further exploration and biopsy should be maintained if an orbital abscess is suspected. This report describes a complex case of WG that illustrates the diagnostic and therapeutic challenges inherent in this form of orbital inflammatory disease.
Gupta
D
D
James Paget University Hospital, Gorelston, United Kingdom. dgupta_01@yahoo.com
Hemmant
B
B
Marshall
T
T
D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy; D000208:Acute Disease; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009916:Orbital Diseases / Q000175:diagnosis* / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D014792:Visual Acuity
D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone