Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis

Yi-Nan Liu; Yi-Ning Guo; Yi-Fan Song; Yan-Jie Tian; Xue-Min Li

doi:10.24920/004150

Your Location：

Home >

Browse articles >

Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis

Chinese Medical Sciences Journal Vol. 38, Issue 1, Pages: 57-61(2023)

Case Report | Updated：2024-03-30

- Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis
- Affiliations：
  
  1. 1Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
  2. 2Beijing Key Laborory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
- Author bio：
  
  *Yan-Jie Tian, E-mail: tianyanjietongxun@163.com;
  Xue-Min Li, lxmlxm66@sina.com.
- Funds：
- DOI：10.24920/004150
  CLC：
- Received：02 August 2022，
  
  Accepted：2022-12-19，
  
  Published Online：12 January 2023，
  
  Published：31 March 2023
- Accepted：
Scan QR Code
Yi-Nan Liu, Yi-Ning Guo, Yi-Fan Song, et al. Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis[J]. Chinese medical sciences journal, 2023, 38(1): 57-61.
DOI：

Yi-Nan Liu, Yi-Ning Guo, Yi-Fan Song, et al. Panscleritis After Blunt Ocular Trauma in A Child with Epididymitis[J]. Chinese medical sciences journal, 2023, 38(1): 57-61. DOI： 10.24920/004150.

摘要

我们报道一例8岁男童因跌倒后眼部外伤导致的左眼全巩膜炎伴发右侧附睾炎的病例。病因诊断在本病例中起到关键作用。寻找巩膜炎病因的全身检查排除了系统性自身免疫性疾病、肿瘤和感染。我们认为巩膜炎系眼外伤所致局部迟发性超敏反应所致，属于非感染性炎症，但右侧附睾炎仍为感染性炎症。巩膜炎和附睾炎分别应用糖皮质激素和抗生素治疗，均取得良好疗效。因此，在疾病早期进行病因诊断和合理治疗是预防视力丧失的关键。

Abstract

We reported an 8-year-old boy with panscleritis in left eye and right epididymitis after falling on the ground. Etiologic diagnosis played a key role in this case. Systemic examinations ruled out systemic autoimmune diseases

tumors

and infections as the cause of scleritis and suggested that the disease was caused by a local delayed-type hypersensitivity (DTH) induced by ocular trauma and was non-infectious. Still

the right epididymitis was infectious. Both conditions were treated successfully using steroids and antibiotics

respectively. Thus

early etiologic diagnosis and reasonable treatment are crucial to prevent visual loss.

关键词

Keywords

references

Cheung CM , Chee SP . Posterior scleritis in children: clinical features and treatment . Ophthalmology 2012 ; 119 ( 1 ): 59 - 65 . doi: 10.1016/j.ophtha.2011.09.030 https://dx.doi.org/10.1016/j.ophtha.2011.09.030 . DOI: 10.1016/j.ophtha.2011.09.030 http://doi.org/10.1016/j.ophtha.2011.09.030

Yang PZ , Ye Z , Tang JH , et al. Clinical features and complications of scleritis in Chinese patients . Ocul Immunol Inflamm 2018 ; 26 ( 3 ): 387 - 96 . doi: 10.1080/09273948.2016.1241282 https://dx.doi.org/10.1080/09273948.2016.1241282 . DOI: 10.1080/09273948.2016.1241282 http://doi.org/10.1080/09273948.2016.1241282

Jabs DA , Mudun A , Dunn JP , et al. Episcleritis and scleritis: clinical features and treatment results . Am J Ophthalmol 2000 ; 130 ( 4 ): 469 - 76 . doi: 10.1016/s0002-9394(00)00710-8 https://dx.doi.org/10.1016/s0002-9394(00)00710-8 . DOI: 10.1016/s0002-9394(00)00710-8 http://doi.org/10.1016/s0002-9394(00)00710-8

Homayounfar G , Borkar DS , Tham VM , et al. Clinical characteristics of scleritis and episcleritis: results from the pacific ocular inflammation study . Ocul Immunol Inflamm 2014 ; 22 ( 5 ): 403 - 4 . doi: 10.3109/09273948.2013.854394 https://dx.doi.org/10.3109/09273948.2013.854394 . DOI: 10.3109/09273948.2013.854394 http://doi.org/10.3109/09273948.2013.854394

Majumder PD , Ali S , George A , et al. Clinical Profile of Scleritis in Children . Ocul Immunol Inflamm 2019 ; 27 : 535 - 9 . doi: 10.1080/09273948.2017.1423333 https://dx.doi.org/10.1080/09273948.2017.1423333 . DOI: 10.1080/09273948.2017.1423333 http://doi.org/10.1080/09273948.2017.1423333

Majumder PD , Agrawal R , McCluskey P , et al. Current Approach for the Diagnosis and Management of Noninfective Scleritis . Asia Pac J Ophthalmol (Phila) 2020 ; 10 ( 2 ): 212 - 23 . doi: 10.1097/APO.0000000000000341 https://dx.doi.org/10.1097/APO.0000000000000341 . DOI: 10.1097/APO.0000000000000341 http://doi.org/10.1097/APO.0000000000000341

Watson PG , Young RD . Scleral structure, organization and disease: A review . Exp Eye Res 2004 ; 78 ( 3 ): 609 - 23 . doi: 10.1016/s0014-4835(03)00212-4 https://dx.doi.org/10.1016/s0014-4835(03)00212-4 . DOI: 10.1016/s0014-4835(03)00212-4 http://doi.org/10.1016/s0014-4835(03)00212-4

Madanagopalan VG , Shivananda N , Krishnan T . Surgically induced necrotizing scleritis after retinal detachment surgery masquerading as scleral abscess . GMS Ophthalmol Cases 2019 ; 9 : Doc18 . doi: 10.3205/oc000107 https://dx.doi.org/10.3205/oc000107 . DOI: 10.3205/oc000107 http://doi.org/10.3205/oc000107

Brandt O , Bircher AJ . Delayed-type hypersensitivity to oral and parenteral drugs . J Dtsch Dermatol Ges 2017 Nov; 15 ( 11 ): 1111 - 32 . doi: 10.1111/ddg.13362 https://dx.doi.org/10.1111/ddg.13362 . DOI: 10.1111/ddg.13362 http://doi.org/10.1111/ddg.13362

O'Donoghue E , Lightman S , Tuft S , et al. Surgically induced necrotising sclerokeratitis (SINS) Fprecipitating factors and response to treatment . Br J Ophthalmol 1992 ; 76 ( 1 ): 17 - 21 . doi: 10.1136/bjo.76.1.17 https://dx.doi.org/10.1136/bjo.76.1.17 . DOI: 10.1136/bjo.76.1.17 http://doi.org/10.1136/bjo.76.1.17 https://bjo.bmj.com/lookup/doi/10.1136/bjo.76.1.17 https://bjo.bmj.com/lookup/doi/10.1136/bjo.76.1.17

Morley AM , Pavesio C . Surgically induced necrotising scleritis following three-port pars plana vitrectomy without scleral buckling: a series of three cases . Eye (Lond) 2008 Jan ; 22 ( 1 ): 162 - 4 . doi: 10.1038/sj.eye.6702708 https://dx.doi.org/10.1038/sj.eye.6702708 . DOI: 10.1038/sj.eye.6702708 http://doi.org/10.1038/sj.eye.6702708

Young RD , Powell J , Watson PG . Ultrastructural changes in scleral proteoglycans precede destruction of the collagen fibril matrix in necrotizing scleritis . Histopathol 1988 ; 12 ( 1 ): 75 - 84 . doi: 10.1111/j.1365-2559.1988.tb01918.x https://dx.doi.org/10.1111/j.1365-2559.1988.tb01918.x . DOI: 10.1111/j.1365-2559.1988.tb01918.x http://doi.org/10.1111/j.1365-2559.1988.tb01918.x http://www.blackwell-synergy.com/toc/his/12/1 http://www.blackwell-synergy.com/toc/his/12/1

Riley GP , Harrall RL , Hazleman BL , et al. Collagenase (MMP1) and (TIMP) in destructive corneal diseaseassociated with rheumatoid arthritis . Eye (Lond) 1995 ; 9 ( Pt 6 ): 703 - 18 . doi: 10.1038/eye.1995.182 https://dx.doi.org/10.1038/eye.1995.182 . DOI: 10.1038/eye.1995.182 http://doi.org/10.1038/eye.1995.182

Di Girolamo N , Lloyd A , McCluskey P , et al. Increased expression of matrix metalloproteinases in vivo in scleritis tissue and in vitro in cultured human scleral fibroblasts . Am J Pathol 1997 ; 150 ( 2 ): 653 - 66 .

Di Girolamo N , McCluskey PJ , Lloyd A , et al. Localisation of stromelysin matrix metalloproteinase-3 and tissue inhibitor of metallo- proteinase TIMP-1 mRNA in scleritis . Ocul Immunol Inflamm 1995 ; 3 ( 3 ): 181 - 94 . doi: 10.3109/09273949509069111 https://dx.doi.org/10.3109/09273949509069111 . DOI: 10.3109/09273949509069111 http://doi.org/10.3109/09273949509069111

Axmann S , Ebneter A , Zinkernagel MS . Imaging of the sclera in patients with scleritis and episcleritis using anterior segment optical coherence tomography . Ocul Immunol Inflamm 2016 ; 24 ( 1 ): 29 - 34 . doi: 10.3109/09273948.2015.1025983 https://dx.doi.org/10.3109/09273948.2015.1025983 . DOI: 10.3109/09273948.2015.1025983 http://doi.org/10.3109/09273948.2015.1025983

Diogo MC , Jager MJ , Ferreira TA . CT and MR imaging in the diagnosis of scleritis . AJNR Am J Neuroradiol 2016 ; 37 ( 12 ): 2334 - 9 . doi: 10.3174/ajnr.A4890 https://dx.doi.org/10.3174/ajnr.A4890 . DOI: 10.3174/ajnr.A4890 http://doi.org/10.3174/ajnr.A4890 http://www.ajnr.org/lookup/doi/10.3174/ajnr.A4890 http://www.ajnr.org/lookup/doi/10.3174/ajnr.A4890

Sainz de la Maza M , Molina N , Gonzalez-Gonzalez LA , et al. Scleritis therapy . Ophthalmology 2012 ; 119 : 51 - 8 . doi: 10.1016/j.ophtha.2011.07.043 https://dx.doi.org/10.1016/j.ophtha.2011.07.043 . DOI: 10.1016/j.ophtha.2011.07.043 http://doi.org/10.1016/j.ophtha.2011.07.043

Ozzello DJ , Kolfenbach JR , Palestine AG . Uveitis specialists and rheumatologists select different therapies for idiopathic nonnecrotizing anterior scleritis . Ophthalmol Ther 2016 ; 5 ( 2 ): 245 - 52 . doi: 10.1007/s40123-016-0067-1 https://dx.doi.org/10.1007/s40123-016-0067-1 . DOI: 10.1007/s40123-016-0067-1 http://doi.org/10.1007/s40123-016-0067-1

Rathinam SR , Gonzales JA , Thundikandy R , et al. Effect of corticosteroid-sparing treatment with mycophenolate mofetil vs methotrexate on inflammation in patients with uveitis . JAMA 2019 ; 322 ( 10 ): 936 -45. doi: 10.1001/jama.2019.12618 https://dx.doi.org/10.1001/jama.2019.12618 . DOI: 10.1001/jama.2019.12618 http://doi.org/10.1001/jama.2019.12618

Jeon HS , Hyon JY , Kim MK , et al. Efficacy and safety of immunosuppressive agents in the treatment of necrotising scleritis: a retrospective, multicentre study in Korea . Br J Ophthalmol 2016 ; 100 ( 8 ): 1066 - 70. doi: 10.1136/bjophthalmol-2015-307462 https://dx.doi.org/10.1136/bjophthalmol-2015-307462 . DOI: 10.1136/bjophthalmol-2015-307462 http://doi.org/10.1136/bjophthalmol-2015-307462

Sharma SM , Damato E , Hinchcliffe AE , et al. Long-term efficacy and tolerability of TNF-alpha inhibitors in the treatment of noninfectious ocular inflammation: an 8-year prospective surveillance study . Br J Ophthalmol 2019 ; 105 ( 9 ): 1256 - 62 . doi: 10.1136/bjophthalmol-2018-312767 https://dx.doi.org/10.1136/bjophthalmol-2018-312767 . DOI: 10.1136/bjophthalmol-2018-312767 http://doi.org/10.1136/bjophthalmol-2018-312767 https://bjo.bmj.com/lookup/doi/10.1136/bjophthalmol-2018-312767 https://bjo.bmj.com/lookup/doi/10.1136/bjophthalmol-2018-312767

Fabiani C , Sota J , Sainz de la Maza M , et al. Effectiveness of TNF-alpha blockade in the treatment of refractory noninfectious scleritis: a multicenter study . Clin Exp Rheumatol 2020 ; 38 ( 6 ): 1138 - 44 .

Ramirez-Ortiz MA , Vasquez-Resendis A . Isolated bilateral posterior scleritis after eye trauma . J AAPOS 2007 ; 11 ( 3 ), 284 - 5 . doi: 10.1016/j.jaapos.2006.09.019 https://dx.doi.org/10.1016/j.jaapos.2006.09.019 . DOI: 10.1016/j.jaapos.2006.09.019 http://doi.org/10.1016/j.jaapos.2006.09.019

Cho YH , Jung J , Lee KH , et al. Clinical features of patients with Behçet's disease and epididymitis . J Urol 2003 ; 170 (4 Pt 1): 1231 - 3 . doi: 10.1097/01.ju.0000081957.90395.4c https://dx.doi.org/10.1097/01.ju.0000081957.90395.4c . DOI: 10.1097/01.ju.0000081957.90395.4c http://doi.org/10.1097/01.ju.0000081957.90395.4c http://www.jurology.com/doi/10.1097/01.ju.0000081957.90395.4c http://www.jurology.com/doi/10.1097/01.ju.0000081957.90395.4c

Views

263

Downloads

CSCD

Alert me when the article has been cited

Submit

Publicity Resources

No data

Related Author

No data

Related Institution

No data

⁰