A 67-year-old Japanese man was diagnosed with granulomatosis with polyangiitis based on the presence of right maxillary sinusitis, proteinase 3 antineutrophil cytoplasmic antibody positivity, and right scleritis. A conjunctival biopsy specimen showed neutrophil-predominant infiltration around the vessels without granuloma. Because there was a risk of blindness, pulsed methylprednisolone and intravenous cyclophosphamide pulse therapy (IVCY) were started. However, it was ineffective, and peripheral ulcerative keratitis newly emerged. We promptly switched the treatment from IVCY to rituximab, and ophthalmologists performed amniotic membrane transplantation, which avoided blindness. The close and effective working relationship between physicians and ophthalmologists improved our patient’s ocular prognosis.
雑誌名
Internal Medicine
巻
57
号
12
ページ
1783 - 1788
発行年
2018-06-15
出版者
日本内科学会
出版者別言語
Japanese Society of Internal Medicine
ISSN
09182918
EISSN
13497235
DOI
10.2169/internalmedicine.0215-17
権利
c 2018 by The Japanese Society of Internal Medicine.
Peripheral Ulcerative Keratitis Associated with Granulomatosis with Polyangiitis Emerging Despite Cyclophosphamide, Successfully Treated with Rituximab
IntMed57_1783.pdf
(1.16MB)
NAOSITEについて