Peripheral Ulcerative Keratitis Associated with Granulomatosis with Polyangiitis Emerging Despite Cyclophosphamide, Successfully Treated with Rituximab

Overview

Journal Intern Med

Specialty General Medicine

Date 2018 Jan 12

PMID 29321417

Citations 10

Authors

Yuya Fujita

Shoichi Fukui

Yushiro Endo

Sosuke Tsuji

Ayuko Takatani

Toshimasa Shimizu

Masataka Umeda

Ayako Nishino

Tomohiro Koga

Shin-Ya Kawashiri

Naoki Iwamoto

Kunihiro Ichinose

Mami Tamai

Hideki Nakamura

Tomoki Origuchi

Ryotaro Ueki

Masafumi Uematsu

Kaori Ishida

Kuniko Abe

Atsushi Kawakami

Affiliations

Soon will be listed here.

Abstract

A 67-year-old Japanese man was diagnosed with granulomatosis with polyangiitis based on the presence of right maxillary sinusitis, proteinase 3 antineutrophil cytoplasmic antibody positivity, and right scleritis. A conjunctival biopsy specimen showed neutrophil-predominant infiltration around the vessels without granuloma. Because there was a risk of blindness, pulsed methylprednisolone and intravenous cyclophosphamide pulse therapy (IVCY) were started. However, it was ineffective, and peripheral ulcerative keratitis newly emerged. We promptly switched the treatment from IVCY to rituximab, and ophthalmologists performed amniotic membrane transplantation, which avoided blindness. The close and effective working relationship between physicians and ophthalmologists improved our patient's ocular prognosis.

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