Case report
Conjunctivitis as a manifestation of Wegener's Granulomatosis

https://doi.org/10.1016/j.joco.2017.11.003Get rights and content
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Abstract

Purpose

To report a case of prolonged conjunctivitis as the manifestation of Granulomatosis with polyangiitis (GPA).

Methods

A 37-year-old man presented with prolonged conjunctivitis which had persisted for one month. He was taking medication for his conjunctivitis without any response. A slit-lamp examination revealed conjunctivitis and scleritis in the right eye. Conjunctivitis, 360-degree peripheral corneal thinning, corneal perforation, and scleritis were seen in the left eye.

Results

Emergency penetrating keratoplasty was performed to treat the patient's corneal perforation. After a consultation with the Internal Medicine Department, the patient was suspected of having GPA with positive cytoplasmic anti-neutrophil cytoplasmic antibodies (C-ANCA). Functional endoscopic sinus surgery was performed to treat right maxillary sinusitis, and a biopsy of the maxillary sinus mucosa was obtained. The pathology report showed granuloma and vasculitis with severe acute and chronic inflammation and few eosinophils; thus, the diagnosis was confirmed.

Conclusion

Because prolonged conjunctivitis occurs only rarely in association with systemic disease, ophthalmologists should be aware of this potential, particularly in patients with GPA.

Keywords

Granulomatosis with polyangiitis
Prolonged conjunctivitis
Scleritis
Keratitis

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Conflicts of interest: None of the authors has conflict of interest with the submission.

Peer review under responsibility of the Iranian Society of Ophthalmology.