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Int Ophthalmol ; 28(1): 35-46, 2008 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17589807

RESUMEN

PURPOSE: To describe the clinical and histopathologic finding of very limited ophthalmic Wegener granulomatosis (WG). METHODS: Thirteen patients with scleritis, orbitopathy, episcleritis, and panuveitis were studied. They presented without evidence of lung or kidney disease, though eight had sinus involvement. We reviewed the biopsies for histopathologic findings consistent with WG, and tested for antineutrophil cytoplasmic antibodies antineutrophil cytoplasmic antibody (ANCA). RESULTS: WG was suggested by granulomatous foci, collagen necrosis, neutrophils/nuclear dust, plasma cells and infiltrating eosinophils. Granular degeneration of the interstitial collagen; mummification of the collagen with disappearance of fibroblastic nuclei; and a polymorphous infiltrate exhibiting plasma cells, lymphocytes, neutrophils, and eosinophils within the epithelioid granulomas should suggest the diagnosis. ANCA test results supported the diagnosis of WG in all cases. CONCLUSION: The described histologic characteristics are highly suggestive of WG. These findings along with clinical or laboratory findings, allow the diagnosis of very limited ophthalmic WG in the absence of systemic involvement.


Asunto(s)
Anticuerpos Anticitoplasma de Neutrófilos/sangre , Dacriocistitis/diagnóstico , Granulomatosis con Poliangitis/diagnóstico , Enfermedades Orbitales/diagnóstico , Panuveítis/diagnóstico , Escleritis/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Ciclofosfamida/uso terapéutico , Dacriocistitis/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Granulomatosis con Poliangitis/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Enfermedades Orbitales/tratamiento farmacológico , Panuveítis/tratamiento farmacológico , Prednisona/uso terapéutico , Escleritis/tratamiento farmacológico , Tomografía Computarizada por Rayos X , Agudeza Visual
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