Herpes Simplex Keratitis in Rheumatoid Arthritis Patients

Purpose: To describe a series of 5 patients with herpes simplex virus keratitis (HSK) and rheumatoid arthritis (RA) under immunosuppressive treatment. Methods: Retrospective study. Detailed data were obtained regarding symptoms and signs at the initial evaluation, treatment, microbiological diagnost...

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Bibliographic Details
Published in:Ocular immunology and inflammation 2016-06, Vol.24 (3), p.282-287
Main Authors: Larrañaga Fragoso, Paula, Boto de los Bueis, Ana, Bravo Ljubetic, Luciano, Del Hierro Zarzuelo, Almudena, Romero Gómez, M. Pilar, Mora Rillo, Marta
Format: Article
Language:English
Subjects:
Acyclovir - therapeutic use
Aged
Antiviral Agents - therapeutic use
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Corneal Stroma - pathology
Corneal Stroma - virology
DNA, Viral - genetics
Female
Herpes simplex keratitis
Herpesvirus 1, Human - genetics
Herpesvirus 1, Human - isolation & purification
Humans
Immunosuppressive Agents - therapeutic use
Keratitis, Herpetic - diagnosis
Keratitis, Herpetic - drug therapy
Keratitis, Herpetic - etiology
Male
Opportunistic Infections - diagnosis
Opportunistic Infections - drug therapy
Opportunistic Infections - etiology
peripheral ulcerative keratitis
Polymerase Chain Reaction
Retrospective Studies
rheumathoid arthritis
stromal keratitis
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Summary:Purpose: To describe a series of 5 patients with herpes simplex virus keratitis (HSK) and rheumatoid arthritis (RA) under immunosuppressive treatment. Methods: Retrospective study. Detailed data were obtained regarding symptoms and signs at the initial evaluation, treatment, microbiological diagnostic tests, evolution, and outcomes. Results: Five patients with HSK and RA were identified. Bilateral involvement occurred in 2 patients (40%). Epithelial keratitis was diagnosed in 5 eyes. Three eyes showed severe melting with eye perforation. Gram-positive bacterial co-infections were common in the group with stromal keratitis. We did not find differences in the evolution of the disease based on anti-rheumatoid treatment. Conclusions: The characteristics of HSK in patients with RA differed from HSK in immunocompetent patients. The stromal keratitis cases were very aggressive and difficult to manage, with perforation and gram-positive bacterial co-infection as frequently associated conditions. Prophylactic therapy at standard doses was unsuccessful to avoid recurrences.
ISSN:0927-3948
1744-5078
DOI:10.3109/09273948.2014.945600