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Corneal vortex keratopathy in childhood-onset systemic lupus erythematosus (c-SLE)

Clinical Rheumatology volume 38, pages 2851–2855 (2019)Cite this article

Abstract

Objective

To describe the prevalence and risk factors associated with corneal vortex keratopathy in a childhood-onset systemic lupus erythematosus (c-SLE) cohort.

Material and methods

Consecutive outpatients with c-SLE were evaluated by a pediatric ophthalmologist and pediatric rheumatologist in an outpatient clinic setting in an urban Children’s Hospital. Demographic, clinical, laboratory, and disease characteristics were documented for each patient. Cumulative drug dosage, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and Systemic Lupus Erythematosus International Collaborating Clinics/American College of Rheumatology damage index (SLICC/ACR-DI) scores were calculated.

Results

A total of 76 c-SLE patients (61 (80.26%) females; mean age = 17.9 (SD ± 3.07)) were included. Ophthalmologic abnormalities were observed in 36 (47.36%) patients of which 16 (21.10%) had corneal vortex keratopathy (p = 0.03). c-SLE patients with corneal vortex keratopathy were all female. We did not observe any additional clinical, laboratory, or treatment feature associated with corneal vortex keratopathy.

Discussion

We observed a high prevalence of corneal vortex keratopathy in female c-SLE. We hypothesize that this finding may be an initial, dose-related toxicity due to antimalarial use. Follow-up studies are necessary to determine if these changes are an early predictor of retinal toxicity due to antimalarial in c-SLE.

Key Points

• Corneal vortex keratopathy was frequently observed in female patients with c-SLE on a chloroquine medication.

• Corneal vortex keratopathy may be an early marker of chloroquine retinopathy.

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Grants

Simone Appenzeller received grants from Fundação Apoio a Pesquisa Estado São Paulo-Brasil (Conselho Nacional Pesquisa Desenvolvimento-Brasil CNPq 304255/2015-7 and 473328/2013-5 and 401477/2016-9), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) Finance Code 001).

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Affiliations

  1. Medical Physiopathology Program School of Medical Science, University of Campinas, Campinas, Brazil

    Luciana Paim-Marques

  2. Pediatric Rheumatology Unit, Albert Sabin Children’s Hospital, Fortaleza, Brazil

    Luciana Paim-Marques

  3. Pediatric Immunology, Rheumatology Unit; Department of Pediatrics/College of Medicine, University of Florida, Gainesville, FL, USA

    Luciana Paim-Marques

  4. CAVIVER- NGO Clinic, Fortaleza, Brazil

    Paula Carneiro & Islane Castro Verçosa

  5. Ophthalmology Unit, General Hospital of Fortaleza, Fortaleza, Brazil

    Islane Castro Verçosa

  6. Autoimmune Laboratory- School of Medical Science, University of Campinas, Campinas, Brazil

    Simone Appenzeller

  7. Rheumatology Unit-Department of Medicine- School of Medical Science, University of Campinas, Campinas, Brazil

    Simone Appenzeller

Authors
  1. Luciana Paim-Marques
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  2. Paula Carneiro
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  3. Islane Castro Verçosa
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  4. Simone Appenzeller
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Correspondence to Simone Appenzeller.

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Paim-Marques, L., Carneiro, P., Verçosa, I.C. et al. Corneal vortex keratopathy in childhood-onset systemic lupus erythematosus (c-SLE). Clin Rheumatol 38, 2851–2855 (2019). https://doi.org/10.1007/s10067-019-04632-z

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  • DOI: https://doi.org/10.1007/s10067-019-04632-z

Keywords

  • Corneal vortex keratopathy
  • Ocular findings
  • Systemic lupus erythematosus