A case of posterior scleritis with ANCA-associated vasculitis syndrome requiring rituximab therapy
Purpose
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a necrotizing vasculitis syndrome with the destruction of small vessels, causing various organ disorders. We report a case of posterior scleritis with ANCA-associated vasculitis treated with prednisolone (PSL) and rituximab (RTX) combination therapy.
Methods
A 69-year-old female had suffered from ocular pain and redness in her left eye for 2 and a half years and visited an eye clinic. Otitis media with unknown etiology was also detected from 1 year ago. Scleral injection was detected, and she was referred to our hospital. At the initial visit, prominent scleral injection with nodular-elevated lesions, vitreous haze and serous retinal detachment (SRD) were observed in her left eye. Enhanced computed tomography demonstrated the enhancement and thickening of her left sclera. Laboratory analysis revealed myeloperoxidase ANCA positive. From these results, her diagnosis was established as ANCA-associated vasculitis.
Results
As the topical treatment exacerbated the vitreous haze and SRD, steroid pulse therapy was then conducted. In respond to the therapy anterior and posterior scleritis subsided, and additional RTX administration was performed to maintain the remission. The dose of PSL could be decreased to 10mg/day until now.
Conclusion
We experienced a case of posterior scleritis with ANCA-associated vasculitis. In addition to steroid pulse therapy, the combination of RTX may contribute to maintaining the remission.
Conflict of interest
No
Author 1
Last name
WENG
Initials of first name(s)
XY
Department
Ophthalmology Faculty of Medicine and Graduate School of Medicine Hokkaido University 1）
City
Sapporo
Country
Japan
Author 2
Last name
IWADA
Initials of first name(s)
D
Department
1）
City
Sapporo
Country
Japan
Author 3
Last name
NAMBA
Initials of first name(s)
K
Department
1）
City
Sapporo
Country
Japan
Author 4
Last name
SUZUKI
Initials of first name(s)
K
Department
1）
City
Sapporo
Country
Japan
Author 5
Last name
MIZUUTI
Initials of first name(s)
K
Department
1）
City
Sapporo
Country
Japan
Author 6
Last name
ISHIDA
Initials of first name(s)
S
Department
1）
City
Sapporo
Country
Japan
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