[Scleritis and systemic diseases: What should know the internist?]
Fiche publication
Date publication
septembre 2018
Journal
La Revue de medecine interne
Auteurs
Membres identifiés du Cancéropôle Est :
Dr DEVILLIERS Hervé
Tous les auteurs :
Bielefeld P, Saadoun D, Héron E, Abad S, Devilliers H, Deschasse C, Trad S, Sène D, Kaplanski G, Sève P
Lien Pubmed
Résumé
Scleritis is an inflammatory disease of the sclera; outer tunic of the eye on which the oculomotor muscles are inserted. It can be associated with a systemic disease up to one time out of 3. These associated diseases are mainly rheumatoid arthritis, vasculitis, including granulomatosis with polyangiitis in the first line and spondyloarthropathies. Before mentioning such an etiology, it is necessary to eliminate an infectious cause, mainly herpetic, which is regularly underestimated. The classification of scleritis is clinical. We distinguish between anterior scleritis and posterior scleritis. Anterior scleritis is diffuse or nodular, usually of good prognosis. Anterior necrotizing scleritis with inflammation is often associated with an autoimmune disease, necrotizing scleritis without inflammation usually reflects advanced rheumatoid arthritis. The treatment of these conditions requires close collaboration between internists and ophthalmologists to decide on the use of corticosteroid therapy with or without immunosuppressors or biotherapies.
Mots clés
Auto-immune disease, Maladie auto-immune, Maladie systémique, Scleritis, Sclérite, Systemic disease, Traitement, Treatment, Vascularite, Vasculitis
Référence
Rev Med Interne. 2018 Sep;39(9):711-720