Peripheral ulcerative keratitis as the presenting feature of systemic rheumatoid vasculitis without joint involvement

Morgan-Warren, Peter J; Dulku, Simon; Ravindran, Jaya; Smith, Gardner W.

doi:10.1007/s10792-013-9879-3

Cited by 9 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, anticyclic citrullinated peptide antibodies (anti-CCP antibodies) are more sensitive than RF, and they are special markers of systemic involvement in RA [50]. Compared with RF, anti-CCP appears to be related to increased and worse ocular manifestation in RA [51]. More recently, other posttranslational modifications (PTMs) associated with RA have been found to include remarkable antibodies [45].…”

Section: Rheumatoid Arthritismentioning

confidence: 99%

Peripheral Ulcerative Keratitis Associated with Autoimmune Disease: Pathogenesis and Treatment

Cao

Zhang

et al. 2017

Journal of Ophthalmology

View full text Add to dashboard Cite

Peripheral ulcerative keratitis (PUK) is type of crescent-shaped inflammatory damage that occurs in the limbal region of the cornea. PUK is always combined with an epithelial defect and the destruction of the peripheral corneal stroma. PUK may have a connection to systemic conditions, such as long-standing rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Wegener granulomatosis (WG), relapsing polychondritis, classic polyarteritis nodosa and its variants, microscopic polyangiitis, and Churg-Strauss syndrome. However, the most common connection is with RA, which is also the focus of this review. The pathogenesis of PUK is still unclear. It is thought that circulating immune complexes and cytokines exert an important influence on the progression of this syndrome. Treatment is applied to inhibit certain aspects of PUK pathogenesis.

show abstract

Section: Rheumatoid Arthritismentioning

confidence: 99%

Peripheral Ulcerative Keratitis Associated with Autoimmune Disease: Pathogenesis and Treatment

Cao

Zhang

et al. 2017

Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…One case presented with RV as a primary symptom, and the disease duration was two (5). The other case presented with ulcerative keratitis as the feature of RV without joint involvement (6). These cases show that RV may occur in new-onset RA or without joint involvement, and the disease duration or progression of RA may vary.…”

Section: Discussionmentioning

confidence: 84%

Severe Mononeuritis Multiplex due to Rheumatoid Vasculitis in Rheumatoid Arthritis in Sustained Clinical Remission for Decades

et al. 2020

View full text Add to dashboard Cite

Rheumatoid vasculitis (RV) usually occurs in patients with refractory rheumatoid arthritis (RA). An 80year-old woman was transferred to our hospital because of muscle weakness and paresthesia in all 4 limbs. She had been diagnosed with RA 30 years ago and achieved sustained clinical remission. At presentation, polyarthritis and drop foot were observed, and rheumatoid factor was prominently elevated. A peripheral nerve conduction test revealed mononeuritis multiplex in her limbs. We suspected that RV had developed rapidly despite RA having been stable for many years and started immunosuppression therapy with steroids combined with azathioprine. The treatment prevented worsening of muscle weakness and paresthesia.

show abstract

“…43 Peripheral ulcerative keratitis develops in chronic HCV infection, with associated necrotising scleritis being a common clinical finding. 44,45,46,47,48,49 The management of choice for HCV infection is interferon-alpha and ribavirin. 43 The patients who were refractory to this have responded well to a combination of interferon-alpha, ribavirin and rituximab.…”

Section: Hepatitis Cmentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

View full text Add to dashboard Cite

Background: Peripheral ulcerative keratitis (PUK) is a severe inflammatory disease of the peripheral cornea that can be caused by local factors or systemic inflammatory disease.Aim: The purpose of this review is to give an overview of the pathophysiology, aetiology, clinical features, diagnosis, and management of PUK.Method: A PubMed search was conducted using the keywords, ‘peripheral ulcerative keratitis’ and ‘Mooren’s ulcer’.Results: The peripheral cornea has unique characteristics the predispose to the development of PUK. These include fine capillary arcades that allow for deposition of immune complexes and subsequent activation of an inflammatory cascade with corneal melt. Several conditions have been implicated in the aetiology of PUK. The most commonly cited causes are rheumatoid arthritis (RA), granulomatosis with polyangiitis (GPA) and various dermatoses. In patients with RA, PUK usually presents in established disease, whereas in GPA, PUK may be the presenting feature in up to 60% of cases. In RA it heralds the onset of a systemic vasculitis with significant associated morbidity and mortality. The management of PUK follows an individualised stepwise approach. All patients require supportive measures to encourage healing and halt the process of keratolysis. Systemic autoimmune conditions need a systemic corticosteroid as a fast-acting agent to halt the inflammatory process while cytotoxic therapy maintains long term disease control. Failure to achieve disease control with CTT, necessitates the use of a biologic agent.Conclusion: Peripheral ulcerative keratitis is a severe inflammatory disease of the peripheral cornea that needs a thorough diagnostic workup and stepwise management approach.

show abstract

Peripheral ulcerative keratitis as the presenting feature of systemic rheumatoid vasculitis without joint involvement

Cited by 9 publications

References 11 publications

Peripheral Ulcerative Keratitis Associated with Autoimmune Disease: Pathogenesis and Treatment

Peripheral Ulcerative Keratitis Associated with Autoimmune Disease: Pathogenesis and Treatment

Severe Mononeuritis Multiplex due to Rheumatoid Vasculitis in Rheumatoid Arthritis in Sustained Clinical Remission for Decades

Peripheral ulcerative keratitis: A review of aetiology and management

Contact Info

Product

Resources

About