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An unusual case of Behcet disease with posterior scleritis: A case report
RATIONALE: Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736338/ https://www.ncbi.nlm.nih.gov/pubmed/31464918 http://dx.doi.org/10.1097/MD.0000000000016886 |
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author | Yanagida, Chihiro Usui, Yoshihiko Sakai, Jun-Ichi Goto, Hiroshi |
author_facet | Yanagida, Chihiro Usui, Yoshihiko Sakai, Jun-Ichi Goto, Hiroshi |
author_sort | Yanagida, Chihiro |
collection | PubMed |
description | RATIONALE: Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet disease. PATIENT CONCERNS: A 50-year-old man previously diagnosed with systemic Behcet disease presented with ocular pain and decreased vision in the left eye. DIAGNOSIS: Posterior scleritis associated with Behcet disease was diagnosed based on optical coherence tomography showing choroidal folds, as well as contrast computed tomography and ultrasound sonography demonstrating thickening of the posterior sclera. INTERVENTIONS: Treatment with systemic corticosteroids was initiated. Since inflammation relapsed during steroid tapering, anti-tumor necrosis factor-alpha (TNF-α) therapy was used in combination, and tapering of steroids was possible without recurrence of inflammation for 12 months. OUTCOMES: Posterior scleritis was resolved and visual acuity improved. With the continuation of TNF-α therapy, oral prednisolone was successfully tapered and discontinued. No relapse of inflammation was observed at follow-up 1 year after discontinuation of prednisolone. LESSONS: Ophthalmologists should be aware of the possibility of rare manifestation of posterior scleritis in patients with Behcet disease, and that combined use of systemic steroids and anti-TNF-α therapy may resolve the scleritis without recurrence of inflammation. |
format | Online Article Text |
id | pubmed-6736338 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-67363382019-10-02 An unusual case of Behcet disease with posterior scleritis: A case report Yanagida, Chihiro Usui, Yoshihiko Sakai, Jun-Ichi Goto, Hiroshi Medicine (Baltimore) 5800 RATIONALE: Posterior scleritis is an ocular inflammatory disorder that can be associated with both infectious and non-infectious immune reactions. Behcet disease is a chronic, relapsing, multisystemic inflammatory disorder with uveitis. There are no reported cases of posterior scleritis with Bechet disease. PATIENT CONCERNS: A 50-year-old man previously diagnosed with systemic Behcet disease presented with ocular pain and decreased vision in the left eye. DIAGNOSIS: Posterior scleritis associated with Behcet disease was diagnosed based on optical coherence tomography showing choroidal folds, as well as contrast computed tomography and ultrasound sonography demonstrating thickening of the posterior sclera. INTERVENTIONS: Treatment with systemic corticosteroids was initiated. Since inflammation relapsed during steroid tapering, anti-tumor necrosis factor-alpha (TNF-α) therapy was used in combination, and tapering of steroids was possible without recurrence of inflammation for 12 months. OUTCOMES: Posterior scleritis was resolved and visual acuity improved. With the continuation of TNF-α therapy, oral prednisolone was successfully tapered and discontinued. No relapse of inflammation was observed at follow-up 1 year after discontinuation of prednisolone. LESSONS: Ophthalmologists should be aware of the possibility of rare manifestation of posterior scleritis in patients with Behcet disease, and that combined use of systemic steroids and anti-TNF-α therapy may resolve the scleritis without recurrence of inflammation. Wolters Kluwer Health 2019-08-30 /pmc/articles/PMC6736338/ /pubmed/31464918 http://dx.doi.org/10.1097/MD.0000000000016886 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 5800 Yanagida, Chihiro Usui, Yoshihiko Sakai, Jun-Ichi Goto, Hiroshi An unusual case of Behcet disease with posterior scleritis: A case report |
title | An unusual case of Behcet disease with posterior scleritis: A case report |
title_full | An unusual case of Behcet disease with posterior scleritis: A case report |
title_fullStr | An unusual case of Behcet disease with posterior scleritis: A case report |
title_full_unstemmed | An unusual case of Behcet disease with posterior scleritis: A case report |
title_short | An unusual case of Behcet disease with posterior scleritis: A case report |
title_sort | unusual case of behcet disease with posterior scleritis: a case report |
topic | 5800 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736338/ https://www.ncbi.nlm.nih.gov/pubmed/31464918 http://dx.doi.org/10.1097/MD.0000000000016886 |
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