Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/27591
ชื่อเรื่อง: Atypical Conjunctival Lesion as the Initial Presentation of Granulomatosis with Polyangiitis in an Adolescent Male
ผู้แต่ง: Sripawadkul W.
Zein M.
Galor A.
Rivas-Chacon R.
Khzam R.A.
Dubovy S.R.
Karp C.L.
Keywords: conjunctival lesion
diagnosis
pediatric granulomatous polyangiitis
วันที่เผยแพร่: 2022
สำนักพิมพ์: Lippincott Williams and Wilkins
บทคัดย่อ: Purpose:The purpose of this study was to report the first case of a conjunctival granulomatous lesion as the presenting sign of granulomatous polyangiitis (GPA) in a pediatric patient.Methods:This study is a case report.Results:A 14-year-old Hispanic boy presented with a conjunctival lesion on the inferior bulbar conjunctiva of the right eye associated with diffuse conjunctival injection. The mass progressively grew and became painful over the course of 6 weeks. No retinal or orbital abnormalities were noted on examination. The lesion was excised, and histopathological analysis was consistent with granulomatous inflammation. The lesion recurred after 15 months, and a second excisional biopsy was performed. The lesion again slowly recurred, and on presentation to our clinic, an elevated lesion in the inferior limbal/bulbar conjunctiva of the right eye was noted from 4 to 8 o'clock with accompanying forniceal shortening. Five months after the second excision, the patient developed flu-like symptoms with polyarthralgia. A full diagnostic workup revealed multiple pulmonary nodules on chest imaging, proteinuria on urinalysis, and a positive c-antineutrophil cytoplasmic antibody on serological studies. Based on these findings, the patient underwent a kidney biopsy which showed pauci-immune crescentic glomerulonephritis, consistent with a diagnosis of GPA. The patient achieved disease remission with rituximab. Despite treatment, the conjunctival lesion did not regress and remained unchanged in size for 3 years with periodic episodes of inflammation.Conclusions:This is the first documented case of a conjunctival mass as the initial presenting feature of pediatric GPA. The presence of granulomatous inflammation on histopathology and recurrences after excision should raise suspicion for GPA in children and adults. © 2022 Lippincott Williams and Wilkins. All rights reserved.
URI: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85133698228&doi=10.1097%2fICO.0000000000003015&partnerID=40&md5=8e85025541eadfc19bf6102768998a9b
https://ir.swu.ac.th/jspui/handle/123456789/27591
ISSN: 2773740
Appears in Collections:Scopus 2022

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