Search

Purpose :To evaluate demographic characteristics, clinical features, systemic disease associations, visual outcomes, and treatment modalities of patients with episcleritis and scleritis in an internal medicine departement Methods :Data from 17 patients with episcleritis and from 23 patients with scleritis followed from 2010 to 2019 were retrospectively evaluated. The main outcome measures were demographics, ocular disease characteristics, presence of systemic associated disease, and treatment regimen. Results :Episcleritis and scleritis were found bilaterally in 62.5 % patients.The episcleritis was diffuse in 11 and focal in 06 patients, while the scleritis was diffuse in 5, nodular in 10, necrotizing in 1, and posterior in 7 patients. An associated systemic disease was found in 27.5%. Conclusion :The importance of differentiating scleritis from episcleritis is remarkable given the significant difference in the degree of ocular complications and associated systemic diseases between these ocular conditions.

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease that is characterized by a multisystemic involvement and various clinical manifestations. Pulmonary manifestations occur in approximately 50% of patients. One of the rare and mortal complications is lupus pneumonitis. Very few cases have been reported due to its rarity and diagnostic challenge. It must be suspected in case of non-response to conventional treatment for pneumonia. We describe the case of a 29-year-old man with lupus pneumonitis as the initial presentation of systemic lupus erythematosus.

Necrotizing fasciitis is a serious soft tissue infection that causes necrosis of the subcutaneous tissues and the muscle fascia. It is associated with a high mortality rate of around 25%. Necrotizing fasciitis of the breast is a rare entity. It is a rapidly progressive life-threatening condition which can lead to sepsis with multiple organ failure. We describe a case of necrotizing fasciitis of the right breast in a 48-year-old patient diagnosed with systemic sclerosis–rheumatoid arthritis overlap syndrome. LEARNING POINTS Necrotizing fasciitis of the breast is a very challenging diagnosis due to its rarity and similarity with simple breast infection. It is a life-threatening condition which can lead to systemic shock and multiple organ dysfunction syndrome and death. It may occur in patients with rheumatic diseases treated with corticosteroids and immunosuppressant drugs. Keywords: Necrotizing fasciitis, autoimmune disease, methotrexate INTRODUCTION Patients with rheumatoid arthritis and systemic sclerosis have higher mortality than the general population. This is due in part to the increasing incidence of infections [1]. We report a case of necrotizing fasciitis (NF) of the right breast in a patient with systemic sclerosis–rheumatoid arthritis overlap syndrome, which had been treated with steroids and methotrexate for 25 years. This is the first reported case of NF of the breast in a patient with a history of autoimmune disease.

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease that is characterized by a multisystemic involvement and various clinical manifestations.Pulmonary manifestations occurin approximately50% of patients. One of the rare and mortal complications islupus pneumonitis. Very few cases have been reported due to its rarity and diagnostic challenge. It must be suspected in case of non-response to conventional treatment for pneumonia. We describe the case of a 29-year-old man with lupus pneumonitis as the initial presentation of systemic lupus erythematosus. &nbsp

Purpose:To evaluate demographic characteristics, clinical features, systemic disease associations, visual outcomes, and treatment modalities of patients with episcleritis and scleritis in an internal medicine departement Methods:Data from 17 patients with episcleritis and from 23 patients with scleritis followed from 2010 to 2019 were retrospectively evaluated. The main outcome measures were demographics,ocular disease characteristics, presence of systemic associated disease, and treatment regimen. Results:Episcleritis and scleritis were found bilaterally in 62.5 % patients.The episcleritis was diffuse in 11 and focal in 06 patients, while the scleritis was diffuse in 5, nodular in 10, necrotizing in 1, and posterior in 7 patients. An associated systemic disease was found in 27.5%. Conclusion:The importance of differentiating scleritis from episcleritis is remarkable given the significant difference in the degree of ocular complications and associated systemic diseases between these ocular conditions.&nbsp

Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin changes (POEMS) syndrome is a typical form of monoclonal gammapathy of clinical significance (MGCS). The acronym MGCS was coined by Jean-Paul Fermand and colleagues(1)to generalise the notion of monoclonal gammapathy of renal significance, in which the toxicity of a monoclonal immunoglobulin produced by a B-cell clone is directed against various renal structures(2). The first case of POEMS syndrome successfully treated with thalidomide was reported in 2004(3). The authors then reported that thalidomide reduced serum VEGF concentrations and increased nerve conduction velocity in nine patients who were not suitable for autotransplantation because of advanced age or severe illness. We aimed to assess the efficacy and safety of thalidomide for the treatment of POEMS syndrome about one case.