Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia

Purpose. To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. Methods. Case report and literature review. Results. A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his...

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Main Authors: Pedro Coelho, Carlos Menezes, Rita Gonçalves, Pedro Rodrigues, Elena Seara
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2017/9461937
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author Pedro Coelho
Carlos Menezes
Rita Gonçalves
Pedro Rodrigues
Elena Seara
author_facet Pedro Coelho
Carlos Menezes
Rita Gonçalves
Pedro Rodrigues
Elena Seara
author_sort Pedro Coelho
collection DOAJ
description Purpose. To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. Methods. Case report and literature review. Results. A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his right eye, associated with redness and photophobia. Medical background elicited a history of Hepatitis C and IV illicit drug abuse. Ocular examination revealed a BCVA of 20/30 of the affected eye and slight discomfort with eye movement. Biomicroscopy revealed a ring shaped peripheral corneal ulcer, with a dense white stromal infiltrate sparing the limbus, plus an adjacent area of mild anterior diffuse nonnecrotizing scleritis. No intraocular inflammation was present. Posterior segment was normal. The patient was placed under oral prednisolone (1 mg/Kg/day) with gradual tapering. A dramatic clinical response occurred, with complete resolution of the clinical condition. Systemic analytic workup aiming at autoimmune and infectious diseases was negative, except for high HCV-viral load and the presence of type 2 cryoglobulins. Conclusion. Albeit rare, cryoglobulinemia, even in the absence of systemic vasculitis, should be considered in the differential diagnosis of PUK, when systemic workout for autoimmune diseases is negative.
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spelling doaj-art-af19fe0e12374467b927d4402ef973802025-08-20T03:39:06ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302017-01-01201710.1155/2017/94619379461937Peripheral Ulcerative Keratitis Associated with HCV-Related CryoglobulinemiaPedro Coelho0Carlos Menezes1Rita Gonçalves2Pedro Rodrigues3Elena Seara4Department of Ophthalmology, Hospital Pedro Hispano, Matosinhos, PortugalDepartment of Ophthalmology, Hospital de Santa Luzia, Viana do Castelo, PortugalDepartment of Ophthalmology, Hospital Pedro Hispano, Matosinhos, PortugalDepartment of Ophthalmology, Hospital Pedro Hispano, Matosinhos, PortugalDepartment of Ophthalmology, Hospital Pedro Hispano, Matosinhos, PortugalPurpose. To describe a case of peripheral ulcerative keratitis associated with type II cryoglobulinemia in the context of Hepatitis C infection. Methods. Case report and literature review. Results. A 36-year-old male patient presented to our emergency department with unilateral moderate pain in his right eye, associated with redness and photophobia. Medical background elicited a history of Hepatitis C and IV illicit drug abuse. Ocular examination revealed a BCVA of 20/30 of the affected eye and slight discomfort with eye movement. Biomicroscopy revealed a ring shaped peripheral corneal ulcer, with a dense white stromal infiltrate sparing the limbus, plus an adjacent area of mild anterior diffuse nonnecrotizing scleritis. No intraocular inflammation was present. Posterior segment was normal. The patient was placed under oral prednisolone (1 mg/Kg/day) with gradual tapering. A dramatic clinical response occurred, with complete resolution of the clinical condition. Systemic analytic workup aiming at autoimmune and infectious diseases was negative, except for high HCV-viral load and the presence of type 2 cryoglobulins. Conclusion. Albeit rare, cryoglobulinemia, even in the absence of systemic vasculitis, should be considered in the differential diagnosis of PUK, when systemic workout for autoimmune diseases is negative.http://dx.doi.org/10.1155/2017/9461937
spellingShingle Pedro Coelho
Carlos Menezes
Rita Gonçalves
Pedro Rodrigues
Elena Seara
Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
Case Reports in Ophthalmological Medicine
title Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_full Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_fullStr Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_full_unstemmed Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_short Peripheral Ulcerative Keratitis Associated with HCV-Related Cryoglobulinemia
title_sort peripheral ulcerative keratitis associated with hcv related cryoglobulinemia
url http://dx.doi.org/10.1155/2017/9461937
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