Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis

Purpose. To report a case of a patient with rheumatoid arthritis (RA) treated with tofacitinib citrate. Methods. Observational case report. Results. A 59-year-old patient, with a history of rheumatoid arthritis, on methotrexate 10 mg PO qwk and IV abatacept 750 mg/month, presented with photosensitiv...

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Main Authors: Philip B. Meadow, Jacqueline Nguyen, Keerthana Kesavarapu
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2014/403452
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author Philip B. Meadow
Jacqueline Nguyen
Keerthana Kesavarapu
author_facet Philip B. Meadow
Jacqueline Nguyen
Keerthana Kesavarapu
author_sort Philip B. Meadow
collection DOAJ
description Purpose. To report a case of a patient with rheumatoid arthritis (RA) treated with tofacitinib citrate. Methods. Observational case report. Results. A 59-year-old patient, with a history of rheumatoid arthritis, on methotrexate 10 mg PO qwk and IV abatacept 750 mg/month, presented with photosensitivity, foreign body sensation, pain, redness, and blurry vision of her right eye (RE). Visual acuity of the RE was 20/200 and 20/20 of the left eye (LE). The slit lamp examination of the RE revealed dryness, 2+ injection of the conjunctiva, and pericentral ulceration of the cornea with 20–30% stromal thinning, pannus, and diffuse punctate epithelial erosions. The anterior chamber appeared normal. Laboratory values revealed elevated levels of rheumatoid factor, anticyclic citrullinated peptide antibodies, and C-reactive protein. The patient was switched to tofacitinib citrate 5 mg PO b.i.d, underwent corneal gluing, and was given prednisone acetate 1% gt TID, polytrim gt TID, neomycin-polymyxin-dexameth gt QD, FreshKote lubricant 1.8% gt QID, moxifloxacin 0.5% gt QID, and preservative free artificial tears Q1H. Within one week, laboratory values normalized, symptoms diminished, and the cornea reepithelialized. Conclusion. RA can present with ulcerative keratitis. Tofacitinib citrate, steroids, and corneal gluing were found to halt the progression of keratolysis and promote reepithelialization.
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spelling doaj-art-b8542d971256426fa63c3ac9c80fbea82025-08-20T02:19:07ZengWileyCase Reports in Rheumatology2090-68892090-68972014-01-01201410.1155/2014/403452403452Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid ArthritisPhilip B. Meadow0Jacqueline Nguyen1Keerthana Kesavarapu2Rivertown Rheumatology P.C., Columbus Regional Health, Columbus, GA 31901, USAPhiladelphia College of Osteopathic Medicine, Suwanee, GA 30024, USAPhiladelphia College of Osteopathic Medicine, Suwanee, GA 30024, USAPurpose. To report a case of a patient with rheumatoid arthritis (RA) treated with tofacitinib citrate. Methods. Observational case report. Results. A 59-year-old patient, with a history of rheumatoid arthritis, on methotrexate 10 mg PO qwk and IV abatacept 750 mg/month, presented with photosensitivity, foreign body sensation, pain, redness, and blurry vision of her right eye (RE). Visual acuity of the RE was 20/200 and 20/20 of the left eye (LE). The slit lamp examination of the RE revealed dryness, 2+ injection of the conjunctiva, and pericentral ulceration of the cornea with 20–30% stromal thinning, pannus, and diffuse punctate epithelial erosions. The anterior chamber appeared normal. Laboratory values revealed elevated levels of rheumatoid factor, anticyclic citrullinated peptide antibodies, and C-reactive protein. The patient was switched to tofacitinib citrate 5 mg PO b.i.d, underwent corneal gluing, and was given prednisone acetate 1% gt TID, polytrim gt TID, neomycin-polymyxin-dexameth gt QD, FreshKote lubricant 1.8% gt QID, moxifloxacin 0.5% gt QID, and preservative free artificial tears Q1H. Within one week, laboratory values normalized, symptoms diminished, and the cornea reepithelialized. Conclusion. RA can present with ulcerative keratitis. Tofacitinib citrate, steroids, and corneal gluing were found to halt the progression of keratolysis and promote reepithelialization.http://dx.doi.org/10.1155/2014/403452
spellingShingle Philip B. Meadow
Jacqueline Nguyen
Keerthana Kesavarapu
Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
Case Reports in Rheumatology
title Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
title_full Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
title_fullStr Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
title_full_unstemmed Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
title_short Tofacitinib Citrate for Ulcerative Keratitis in a Patient with Rheumatoid Arthritis
title_sort tofacitinib citrate for ulcerative keratitis in a patient with rheumatoid arthritis
url http://dx.doi.org/10.1155/2014/403452
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