1. Unusual presentation of a case of Sjogren's syndrome with neurological and ocular manifestation
- Author
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Naina R. Bamrolia, Usha Yadava, and Ritu Arora
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Anti-nuclear antibody ,Diagnosis, Differential ,Necrosis ,medicine ,Humans ,Rheumatoid factor ,Glucocorticoids ,Corneal epithelium ,Anti-neutrophil cytoplasmic antibody ,Keratitis ,Autoimmune disease ,business.industry ,General Medicine ,Conjunctivitis ,medicine.disease ,eye diseases ,Ophthalmology ,Sjogren's Syndrome ,medicine.anatomical_structure ,Prednisolone ,Tarsorrhaphy ,sense organs ,medicine.symptom ,business ,Conjunctiva ,Immunosuppressive Agents ,Follow-Up Studies ,Scleritis ,Optometry ,medicine.drug - Abstract
Sjogren's syndrome is an autoimmune disease that commonly presents to the ophthalmologist as a dry eye disease. We report an unusual presentation of a case of Sjogren's syndrome. A 33-year-old man presented with lid swelling, pseudomembraneous conjunctivitis with central corneal epithelial defect and history of limb weakness for past 2 years. There was progressive enlargement of the epithelial defect and conjunctival-scleral necrosis developed during follow-up. Evaluation for underlying connective tissue disorder was positive for SS-B/La antibody and, the rheumatoid factor, anti nuclear antibody, anti neutrophil cytoplasmic antibody titres were negative. Patient was diagnosed as a case of Primary Sjogren's syndrome. Resolution of the conjunctival-scleral necrosis occurred following treatment with combination of cyclosporine and prednisolone. Paramedian tarsorrhaphy was performed to promote healing of the corneal epithelium. The corneal epithelium healed, conjunctival-scleral necrosis resolved completely and the visual acuity improved to 6/36 in the right eye after 3 months of immunosuppressive therapy. The immunosuppressive therapy was discontinued after completion of 6 months of treatment. After 6 months follow-up of stopping immunosuppressive therapy, the ocular and systemic condition is stable.
- Published
- 2012
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