Case report: A Rare Yet Life Threatening Mimicker of Chronic Conjunctivitis
DOI:
https://doi.org/10.51200/bjms.v11i2.554Keywords:
Scleritis, Wegener's Granulomatosis, chronic conjunctivitisAbstract
Wegener’s granulomatosis (WG) is a necrotizing granulomatous inflammation. A 40-year-old lady of Malay descent presented with unresolving bilateral painful red eyes for three weeks. Clinical examination revealed that best corrected vision acuity of 6/9 for both eyes. Slit lamp examination revealed diffuse scleritis. Other Investigations result like UFEME blood cell: 2+, C-reactive protein 70.06 mg/L and ESR of 125mm/h suggestive on acute inflammations. Connective tissue screening revealed cytoplasmic ANCA was positive and was supported by Anti –Serine Protease3 (PR3) 68. All the investigations results revealed that she had Wegener’s granulomatosis with ophthalmology manifestation in the form scleritis. Patient was treated with guttae Maxidex QID to reduce cells that present in anterior chamber and oral ibuprofen 400mg thrice daily. Subsequently, commence oral prednisolone, oral cyclophosphamide with oral Bactrim. Patient responded well and redness resolved. There are many differential diagnosis for chronic conjunctivitis but to rule out connective tissue disease should be one of the primary differential diagnosis in young female. Oral immunosuppressive and Trimethoprim /Sufmethoxazole (Bactrim) has been found beneficial and symptoms were resolved . Wegener's granulomatosis is a great mimicker as exemplified in this case. This disease can be misdiagnosed and maltreated as conjunctivitis.Thus we wished to emphasize that WG is one the differential that need to be consider in a person with bilateral scleritis.Â
References
REFERENCES
Jennette, J. C., Falk, (2012). Revised International Chapel Hill consensus conference nomenclature of vasculitides. Arthritis and Rheumatism 65(1), 1-11.
Ramsey, Michael K., and Debbie Owens. (2006). Wegener’s Granulomatosis: A Review of the Clinical Implications, Diagnosis, and Treatment. Laboratory Medicine 37(2): 114-116.
Halshtok O,Eshet Y. (2010). Computed tomography scan in necrotizing granulomatosis .Isr Med Assoc J 12:191.
Csernok E, Holle J, Hellmich B, Willem,J, Tervaert C, Kallenberg CG. (2004). Evaluation of capture ELISA for detection of antineutrophil cytoplasmic antibodies directed against proteinase 3 in Wegener‘s granulamatosis :first results from a multicentre study. Rheumatology 43:174-80.
Lapraik, C., R. Watts, P. Bacon, D. Carruthers, K. Chakravarty, D. D’Cruz, L. Guillevin. (2007). BSR and BHPR guidelines for the management of adults with ANCA associated vasculitis. Rheumatology 46 (10): 1615-16.
Popa ER, Tervaert JW. (2003).The Relation between Staphyloccus aureus and Wegener’s granulomatosis: Current knowledge and future directions. Internal Medicine 42:771-80.
Stegeman CA, Tervaert JWC, Jong PE, Kallenberg GM. (1996). Trimethoprim–Sulfamethoxazole (Co-Trimoxazole) for the Prevention of Relapses of Wegener's Granulomatosis. N Engl J Med 335:16-20.
Downloads
Published
How to Cite
Issue
Section
License
Borneo Journal of Medical Sciences
Copyright transfer and contributions agreement to publish in Borneo Journal of Medical Sciences (BJMS)
Transfer our author right to Borneo Journal of Medical Sciences (BJMS Publishers) along with title, interest in article without any limitations. The Journal shall own the work, including 1) copyright; 2) the right to grant permission to republish the article in whole or in part, with or without fee; 3) the right to produce preprints or reprints and translate into languages other than English for sale or free distribution; and 4) the right for electronic/visual reproduction, electronic storage and to republish the work in a collection of articles in any other mechanical or electronic format or printed publications.
We, the authors certify to participate sufficiently in the intellectual content, conception and design of this work or the analysis and interpretation of the data (when applicable), as well as the writing of the manuscript, to take public responsibility for it and have agreed to have our name listed as a contributor. We believe the manuscript represents valid work. Neither this manuscript nor one with substantially similar content under our authorship has been published or is being considered for publication elsewhere, except as described in the covering letter. Any such involvement, publishers of BJMS are not responsible and the authors are held for any untoward practices if any. Any other reproduction of the said article requires the permission from the publisher.
Authors also state that, the work is original and is not infringing with the rights of others and copyrights. Author also further declares that, each co-author have contributed significantly and have accepted to be co-authors for their significant contribution for the work.
We certify that all the data collected during the study is presented in this manuscript and no data from the study has been or will be published separately. We attest that, if requested by the editors, we will provide the data/information or will cooperate fully in obtaining and providing the data/information on which the manuscript is based, for examination by the editors or their assignees.
We give the rights to the corresponding author to make necessary changes as per the request of the journal, do the rest of the correspondence on our behalf and he/she will act as the guarantor for the manuscript on our behalf. All persons who have made substantial contributions to the work reported in the manuscript, but who are not contributors, are named in the Acknowledgment and have given us their written permission to be named. If we do not include an Acknowledgment that means we have not received substantial contributions from non-contributors and no contributor has been omitted.
Total Views: 319
| 
Total Downloads: 125
| Total Downloads: 0
| Total Downloads: 0
| Total Downloads: 0
1.png){kind=logo}
