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Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia

PURPOSE: To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. METHODS: Case report and literature review. RESULTS: A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his...

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Autores principales: Coelho, Pedro, Menezes, Carlos, Gonçalves, Rita, Rodrigues, Pedro, Seara, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5529636/
https://www.ncbi.nlm.nih.gov/pubmed/28785498
http://dx.doi.org/10.1155/2017/9461937
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author Coelho, Pedro
Menezes, Carlos
Gonçalves, Rita
Rodrigues, Pedro
Seara, Elena
author_facet Coelho, Pedro
Menezes, Carlos
Gonçalves, Rita
Rodrigues, Pedro
Seara, Elena
author_sort Coelho, Pedro
collection PubMed
description PURPOSE: To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. METHODS: Case report and literature review. RESULTS: A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his right eye, associated with redness and photophobia. Medical background elicited a history of Hepatitis C and IV illicit drug abuse. Ocular examination revealed a BCVA of 20/30 of the affected eye and slight discomfort with eye movement. Biomicroscopy revealed a ring shaped peripheral corneal ulcer, with a dense white stromal infiltrate sparing the limbus, plus an adjacent area of mild anterior diffuse nonnecrotizing scleritis. No intraocular inflammation was present. Posterior segment was normal. The patient was placed under oral prednisolone (1 mg/Kg/day) with gradual tapering. A dramatic clinical response occurred, with complete resolution of the clinical condition. Systemic analytic workup aiming at autoimmune and infectious diseases was negative, except for high HCV-viral load and the presence of type 2 cryoglobulins. CONCLUSION: Albeit rare, cryoglobulinemia, even in the absence of systemic vasculitis, should be considered in the differential diagnosis of PUK, when systemic workout for autoimmune diseases is negative.
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spelling pubmed-55296362017-08-07 Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia Coelho, Pedro Menezes, Carlos Gonçalves, Rita Rodrigues, Pedro Seara, Elena Case Rep Ophthalmol Med Case Report PURPOSE: To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. METHODS: Case report and literature review. RESULTS: A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his right eye, associated with redness and photophobia. Medical background elicited a history of Hepatitis C and IV illicit drug abuse. Ocular examination revealed a BCVA of 20/30 of the affected eye and slight discomfort with eye movement. Biomicroscopy revealed a ring shaped peripheral corneal ulcer, with a dense white stromal infiltrate sparing the limbus, plus an adjacent area of mild anterior diffuse nonnecrotizing scleritis. No intraocular inflammation was present. Posterior segment was normal. The patient was placed under oral prednisolone (1 mg/Kg/day) with gradual tapering. A dramatic clinical response occurred, with complete resolution of the clinical condition. Systemic analytic workup aiming at autoimmune and infectious diseases was negative, except for high HCV-viral load and the presence of type 2 cryoglobulins. CONCLUSION: Albeit rare, cryoglobulinemia, even in the absence of systemic vasculitis, should be considered in the differential diagnosis of PUK, when systemic workout for autoimmune diseases is negative. Hindawi 2017 2017-07-12 /pmc/articles/PMC5529636/ /pubmed/28785498 http://dx.doi.org/10.1155/2017/9461937 Text en Copyright © 2017 Pedro Coelho et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Coelho, Pedro
Menezes, Carlos
Gonçalves, Rita
Rodrigues, Pedro
Seara, Elena
Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_full Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_fullStr Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_full_unstemmed Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_short Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_sort peripheral ulcerative keratitis associated with hcv-related cryoglobulinemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5529636/
https://www.ncbi.nlm.nih.gov/pubmed/28785498
http://dx.doi.org/10.1155/2017/9461937
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