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Giant cell arteritis and scleritis: A rare association

BACKGROUND: Giant cell arteritis (GCA) is a vasculitis of the large and medium-sized arteries in the elderly whose ischemic complications adversely affect the eye. The irreversible loss of visual acuity is most often related to acute anterior ischemic optic neuropathy. Very few cases of scleritis ha...

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Autor principal: Zulfiqar, Abrar-Ahmad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Babol University of Medical Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348205/
https://www.ncbi.nlm.nih.gov/pubmed/35974946
http://dx.doi.org/10.22088/cjim.13.3.642
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author Zulfiqar, Abrar-Ahmad
author_facet Zulfiqar, Abrar-Ahmad
author_sort Zulfiqar, Abrar-Ahmad
collection PubMed
description BACKGROUND: Giant cell arteritis (GCA) is a vasculitis of the large and medium-sized arteries in the elderly whose ischemic complications adversely affect the eye. The irreversible loss of visual acuity is most often related to acute anterior ischemic optic neuropathy. Very few cases of scleritis have been described in the literature. CASE PRESENTATION: The patient presented an obvious case of giant cell arteritis, initially revealed by an ophthalmologic involvement in the form of posterior scleritis, an ear, nose, and throat (ENT) involvement with vestibular and neurological involvement with a type of peripheral neuropathy, all evolving in the context of a weight loss of 8 kg and a marked biological inflammatory syndrome. The patient presented several relapses of giant cell arteritis in the form of several episodes of anterior and posterior, right and left, and even bilateral, isolated scleritis without any other clinical or biological abnormalities, always in conjunction with a decrease in corticosteroid therapy. In the presence of corticosteroid dependence and resistance to methotrexate, tocilizumab was initiated. CONCLUSION: The therapeutic management of scleritis associated with giant cell arteritis is difficult. In the absence of a codified scheme, the treatment remains empirical, based on the experience of the various teams. In this context, biotherapies (anti-IL6 type, such as tocilizumab) are increasingly used.
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spelling pubmed-93482052022-08-15 Giant cell arteritis and scleritis: A rare association Zulfiqar, Abrar-Ahmad Caspian J Intern Med Case Report BACKGROUND: Giant cell arteritis (GCA) is a vasculitis of the large and medium-sized arteries in the elderly whose ischemic complications adversely affect the eye. The irreversible loss of visual acuity is most often related to acute anterior ischemic optic neuropathy. Very few cases of scleritis have been described in the literature. CASE PRESENTATION: The patient presented an obvious case of giant cell arteritis, initially revealed by an ophthalmologic involvement in the form of posterior scleritis, an ear, nose, and throat (ENT) involvement with vestibular and neurological involvement with a type of peripheral neuropathy, all evolving in the context of a weight loss of 8 kg and a marked biological inflammatory syndrome. The patient presented several relapses of giant cell arteritis in the form of several episodes of anterior and posterior, right and left, and even bilateral, isolated scleritis without any other clinical or biological abnormalities, always in conjunction with a decrease in corticosteroid therapy. In the presence of corticosteroid dependence and resistance to methotrexate, tocilizumab was initiated. CONCLUSION: The therapeutic management of scleritis associated with giant cell arteritis is difficult. In the absence of a codified scheme, the treatment remains empirical, based on the experience of the various teams. In this context, biotherapies (anti-IL6 type, such as tocilizumab) are increasingly used. Babol University of Medical Sciences 2022 /pmc/articles/PMC9348205/ /pubmed/35974946 http://dx.doi.org/10.22088/cjim.13.3.642 Text en https://creativecommons.org/licenses/by/3.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/ (https://creativecommons.org/licenses/by/3.0/) ) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Zulfiqar, Abrar-Ahmad
Giant cell arteritis and scleritis: A rare association
title Giant cell arteritis and scleritis: A rare association
title_full Giant cell arteritis and scleritis: A rare association
title_fullStr Giant cell arteritis and scleritis: A rare association
title_full_unstemmed Giant cell arteritis and scleritis: A rare association
title_short Giant cell arteritis and scleritis: A rare association
title_sort giant cell arteritis and scleritis: a rare association
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9348205/
https://www.ncbi.nlm.nih.gov/pubmed/35974946
http://dx.doi.org/10.22088/cjim.13.3.642
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