title: Orbital presentation of systemic vasculitis: a diagnostic and management challenge.
abstract: BACKGROUND
  Orbital involvement in Wegener's Granulomatosis (WG) is rare and has an overall good prognosis.
  
  
  METHODS
  A 60-year-old hypertensive Indian female presented with vision loss and painful proptosis of left eye. Orbital incisional biopsy suggested necrotising small vessel inflammation. The saddle nose deformity and pedal nodulo- ulcerative lesions further consolidated the diagnosis of Wegener's granulomatosis. Systemic immunosuppressant provided remission and the only relapse was managed successfully with intravenous Rituximab.
  
  
  CONCLUSIONS
  Wegener's granulomatosis should be kept in the differential diagnosis of painful proptosis with a diffuse orbital mass in an elderly patient presenting with profound vision loss. Newer immune modulating agents are useful adjuncts in preventing relapses of this fatal disease.
authors.affiliation: Department of Ophthalmic Plastic and Reconstructive Surgery Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India.
authors.forename: M
authors.initials: M
authors.lastname: Singh
authors.forename: U
authors.initials: U
authors.lastname: Singh
authors.forename: Z
authors.initials: Z
authors.lastname: Zadeng
mesh_terms: D005094:Exophthalmos / Q000175:diagnosis*; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007262:Infusions, Intravenous; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis* / Q000188:drug therapy; D000069283:Rituximab / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab