title: Ophthalmic presentation of Wegener's granulomatosis on a background of polymyalgia rheumatica.
abstract: We present a case of Wegener's granulomatosis (WG) in a 79-year-old man with limbitis and granulomatous conjunctivitis, on a background of polymyalgia rheumatica (PMR). The undifferentiated nature of ocular presentations of WG can be diagnostically challenging, especially in cases, such as this, where findings are initially inconclusive and evolve with time. This case highlights the significance of a history of PMR in patients with ocular inflammation. The systemic inflammatory systems of WG, including arthralgias, may mimic other conditions such as PMR. Patients with undifferentiated ocular inflammatory syndromes should be questioned regarding arthralgias, myalgias and stiffness. Such symptoms, or a background of PMR, should raise suspicion of WG.
authors.affiliation: Save Sight Institute, Sydney Eye Hospital, Australia. ggclark@hotmail.com <ggclark@hotmail.com>
authors.forename: Georgina C
authors.initials: GC
authors.lastname: Clark
authors.forename: Gregory
authors.initials: G
authors.lastname: Moloney
authors.forename: Gerard
authors.initials: G
authors.lastname: Sutton
mesh_terms: D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007637:Keratoconjunctivitis / Q000175:diagnosis* / Q000188:drug therapy; D016850:Limbus Corneae / Q000187:drug effects / Q000473:pathology*; D008297:Male; D011111:Polymyalgia Rheumatica / Q000150:complications*
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide