Recalcitrant granulomatous sclerouveitis in a patient with granulomatous ANCA-associated vasculitis.
OBJECTIVE
To report an unusual case of granulomatous sclerochoroiditis.


METHODS
Interventional case report.


METHODS
A patient with ANCA-associated granulomatous vasculitis presented with nodular necrotizing scleritis, which was recalcitrant to multiple systemic immunosuppressive therapies and progressed to a blind painful eye, which was enucleated.


RESULTS
Histopathology revealed extensive occlusive vasculitis, diffuse T- and B- cellular infiltration, and lymphoid granulomatous formation. Enhanced MHC class II antigens, adhesion molecules, and Fas (CD95) and FasL (CD95L) were detected in the lesion.


CONCLUSIONS
Granulomatous sclerochoroiditis with aggressive immune reaction can be a complication of ANCA-associated granulomatous vasculitis.
St. Luke's Cataract and Laser Center, St. Petersburg, Florida 33702, USA. gclarke@stlukeseye.com
Grace
G
Levy-Clarke
Xiaoyan
X
Ding
Sapna
S
Gangaputra
Steven
S
Yeh
Todd
T
Goodglick
Gordon
G
Byrnes
Robert
R
Nussenblatt
Chi-Chao
CC
Chan
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001766:Blindness / Q000209:etiology; D015862:Choroid Diseases / Q000150:complications / Q000473:pathology; D004351:Drug Resistance; D005654:Fundus Oculi; D006099:Granuloma / Q000150:complications / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007866:Leg; D008297:Male; D012163:Retinal Detachment / Q000150:complications / Q000473:pathology; D015423:Scleritis / Q000150:complications / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D014605:Uveitis / Q000150:complications / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents