title: Pathogenesis of Vernal Keratoconjunctivitis and Associated Factors.
abstract: OBJECTIVE
  To investigate the role of some variables, including allergy and autoimmunity, in the pathogenesis of vernal keratoconjunctivitis (VKC). The VKC is a chronic and often severe form of bilateral keratoconjunctivitis. Usually, it begins during the first decade and disappears during the end of the second decade of life.
  
  
  METHODS
  26 patients with VKC were selected. The diagnosis was performed by the ophthalmologist through a score based on ocular signs and subjective symptoms before and after administration of 1% cyclosporine A (Cy) eyedrops. Each variable was graded: 0 = absent; 1 = mild; 2 = moderate; 3 = severe. Patients with a total score ≥7 were included in the study. Blood samples were collected at the initial time for the determination of autoimmunity by total IgE and antinuclear antibodies (ANA). A Skin Prick Test (SPT) was performed on each patient to common inhalants and food allergens.
  
  
  RESULTS
  53.8% of the children resulted atopic. The most important allergens were house dust mites and grasses. 46.1% of the patients showed total IgE >100 UI/ml and 30.8% had ANA positivity at the first determination. The photophobia occurred in 42.3% of children, most frequently with respect to other symptoms like secretion or tearing (30.8%), foreign body sensation (15.4%), itching and conjunctival hyperemia (11.5%).
  
  
  CONCLUSIONS
  Fortunately all children improved their symptoms after Cy eyedrop therapy. Moreover, there was an elevated percentage (30.8%) of children with ANA positivity compared with the values in the general pediatric population. Despite the fact that it is a non-specific autoantibody, its high presence in a population of children with VKC may have an important role in clarifying etiopathogenesis and chronic inflammation.
authors.affiliation: a Department of Sense Organs , Sapienza University of Rome , Rome , Italy , and.
authors.forename: Marcella
authors.initials: M
authors.lastname: Nebbioso
authors.affiliation: b Department of Pediatrics , Policlinico Umberto I, Sapienza University of Rome , Rome , Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Zicari
authors.affiliation: b Department of Pediatrics , Policlinico Umberto I, Sapienza University of Rome , Rome , Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Celani
authors.affiliation: b Department of Pediatrics , Policlinico Umberto I, Sapienza University of Rome , Rome , Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Lollobrigida
authors.affiliation: a Department of Sense Organs , Sapienza University of Rome , Rome , Italy , and.
authors.forename: Roberto
authors.initials: R
authors.lastname: Grenga
authors.affiliation: b Department of Pediatrics , Policlinico Umberto I, Sapienza University of Rome , Rome , Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Duse
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003233:Conjunctivitis, Allergic / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D007073:Immunoglobulin E / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D018613:Microscopy, Confocal; D009883:Ophthalmic Solutions; D012307:Risk Factors; D012882:Skin Tests; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000485:Allergens; D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions; D007073:Immunoglobulin E; D016572:Cyclosporine
keywords: Conjunctivitis; cyclosporine A; keratitis; keratoconjunctivitis; vernal keratoconjunctivitis; vernal score