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Conjunctivitis lignosa

Ligneous conjunctivitis

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A Leserbrief to this article was published on 15 September 2016

A Leserbrief to this article was published on 18 August 2016

Zusammenfassung

Fallbericht

Wir berichten über eine 3-jährige Patientin mit therapierefraktärer, rezidivierender Konjunktivitis mit Membranbildung des Oberlides. Nach chirurgischer Abtragung zeigte sich histologisch ein zur Conjunctivitis lignosa passendes Bild. Ein manifester Serum-Plasminogenmangel (22 %) untermauerte die Diagnose.

Therapie

Unter Behandlung mit kortikoidhaltigen, heparinhaltigen und Fresh-Frozen-Plasma (FFP)-Augentropfen, erneuter chirurgischer Abtragung mit perioperativer intravenöser FFP-Gabe sowie lokaler Ciclosporin-A-Therapie zeigte sich ein stabiler Befund mit niedriger Krankheitsaktivität.

Schlussfolgerung

Die Kombination dieser Therapieverfahren wurde hier erstmalig durchgeführt und bisher in der Literatur nicht beschrieben.

Abstract

Case report

We report the case of a 3-year-old female patient with therapy refractive recurrent conjunctivitis and membrane formation of the upper eyelid. After surgical removal the histological examination showed an image compatible with ligneous conjunctivitis. A manifest serum plasminogen deficiency (22 %) supported the diagnosis.

Treatment

The treatment with corticosteroids, heparin-containing and fresh frozen plasma (FFP) eye drops, renewed surgical ablation with perioperative intravenous FFP administration and local cyclosporine A eye drops achieved a stable condition with low disease activity.

Conclusion

The combination of these therapy approaches has been performed here for the first time and has not been described in the literature so far.

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Literatur

  1. Azad N, Zafar S, Khan A (2009) Successful treatment of ligneous conjunctivitis with topical cyclosporine and heparin. J AAPOS 13:519–520

  2. Hiremath M, Elder J, Newall F et al (2011) Heparin in the long-term management of ligneous conjunctivitis: a case report and review of literature. Blood Coagul Fibrinolysis 22:606–609

  3. Kuonen A, Vaudaux J, Hamedani M et al (2013) Ligneous conjunctivitis in a young patient with homozygous K19E plasminogen gene mutation: a diagnostic and therapeutic challenge. Klin Monbl Augenheilkd 230:e18

  4. Mehta R, Shapiro AD (2008) Plasminogen deficiency. Haemophilia 14:1261–1268

  5. Pergantou H, Likaki D, Fotopoulou M et al (2011) Management of ligneous conjunctivitis in a child with plasminogen deficiency. Eur J Pediatr 170:1333–1336

  6. Schuster V, Seregard S (2003) Ligneous conjunctivitis. Surv Ophthalmol 48:369–388

  7. Tefs K, Gueorguieva M, Klammt J et al (2006) Molecular and clinical spectrum of type I plasminogen deficiency: a series of 50 patients. Blood 108:3021–3026

  8. Tiede K, Sladek M, Eisend S (2013) Portionierung von Fresh-Frozen-Plasma Augentropfen zur Behandlung von lignöser Konjunktivitis eines Kindes. Krankenhauspharmazie 34:331–332

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Authors and Affiliations

  1. Klinik für Ophthalmologie, UKSH, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland

    M. Bauer, S. Koinzer, J. Roider & B. Nölle

  2. Institut für Pathologie, UKSH, Campus Kiel, Kiel, Deutschland

    I. Oschlies

  3. Klinik für Allgemeine Pädiatrie, UKSH Campus Kiel, Kiel, Deutschland

    A. Claviez

  4. UKSH, Campus Kiel, Apotheke des Universitätsklinikums Schleswig-Holstein, Kiel, Deutschland

    K. Tiede

Authors
  1. M. Bauer
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  2. S. Koinzer
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  3. I. Oschlies
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  4. A. Claviez
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  5. K. Tiede
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  6. J. Roider
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  7. B. Nölle
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Corresponding author

Correspondence to M. Bauer.

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Interessenkonflikt

M. Bauer, S. Koinzer, I. Oschlies, A. Claviez, K. Tiede, J. Roider und B. Nölle geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

Additional information

Die Ergebnisse der Arbeit wurden auf dem DOG-Kongress 2014 in Leipzig präsentiert.

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Bauer, M., Koinzer, S., Oschlies, I. et al. Conjunctivitis lignosa. Ophthalmologe 113, 416–419 (2016). https://doi.org/10.1007/s00347-015-0097-4

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  • DOI: https://doi.org/10.1007/s00347-015-0097-4

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