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Ocul Immunol Inflamm ; 24(3): 282-7, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25140583

RESUMO

PURPOSE: To describe a series of 5 patients with herpes simplex virus keratitis (HSK) and rheumatoid arthritis (RA) under immunosuppressive treatment. METHODS: Retrospective study. Detailed data were obtained regarding symptoms and signs at the initial evaluation, treatment, microbiological diagnostic tests, evolution, and outcomes. RESULTS: Five patients with HSK and RA were identified. Bilateral involvement occurred in 2 patients (40%). Epithelial keratitis was diagnosed in 5 eyes. Three eyes showed severe melting with eye perforation. Gram-positive bacterial co-infections were common in the group with stromal keratitis. We did not find differences in the evolution of the disease based on anti-rheumatoid treatment. CONCLUSIONS: The characteristics of HSK in patients with RA differed from HSK in immunocompetent patients. The stromal keratitis cases were very aggressive and difficult to manage, with perforation and gram-positive bacterial co-infection as frequently associated conditions. Prophylactic therapy at standard doses was unsuccessful to avoid recurrences.


Assuntos
Artrite Reumatoide/complicações , Ceratite Herpética/etiologia , Infecções Oportunistas/etiologia , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Substância Própria/patologia , Substância Própria/virologia , DNA Viral/genética , Feminino , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/isolamento & purificação , Humanos , Imunossupressores/uso terapêutico , Ceratite Herpética/diagnóstico , Ceratite Herpética/tratamento farmacológico , Masculino , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/tratamento farmacológico , Reação em Cadeia da Polimerase , Estudos Retrospectivos
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