Azathioprine and prednisone combination treatment for adult periocular and orbital xanthogranulomatous disease.
OBJECTIVE
To report the authors' experience with azathioprine and prednisone combination for adult periocular and orbital xanthogranulomatous disease.


METHODS
We identified 13 adults with histology-proven periocular or orbital xanthogranuloma in two tertiary referral orbital centres from 1984 to 2008. Patient records were reviewed and data collected on orbital localization, immune dysfunction, applied treatment and outcome.


RESULTS
Five patients with periocular or orbital xanthogranulomatous disease were fully treated with prednisone and azathioprine combination, which resulted in stabilization in two and regression in three. Two other patients had to discontinue azathioprine because of side-effects. Of the non-fully treated prednisone/azathioprine patients, four out of eight progressed.


CONCLUSIONS
In adult periocular and orbital xanthogranuloma, combined treatment with prednisone and azathioprine yields adequate immunosuppression, often for a prolonged period of time.
Bijlsma
Ward R
WR
University Medical Centre Utrecht, Department of Ophthalmology, Heidelberglaan, Utrecht, The Netherlands. w.r.bijlsma@umcutrecht.nl
van den Bosch
Willem A
WA
van Daele
Paul L A
PL
Paridaens
Dion
D
D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use*; D003229:Conjunctival Diseases / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005128:Eye Diseases / Q000188:drug therapy; D005141:Eyelid Diseases / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006099:Granuloma / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007766:Lacrimal Apparatus Diseases / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*; D016896:Treatment Outcome; D014973:Xanthomatosis / Q000188:drug therapy*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D001379:Azathioprine; D011241:Prednisone