ABSTRACT
Objective To report the clinical and magnetic resonance imaging(MRI)features of 5 eases with idiopathic orbital myositis.Methods Four females and one male,aged 27 to 57 years,presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009.The duration of disease Was between 3 months and 4 years.Recurrent course appeared in 3 of them.0rbital MRI Was performed in all of them.After diagnosis they underwent long.term corticosteroid treatment.Results All patients presented ocular pain,asymmetrical and incomplete ophthalmoplegia and mild proptosis.EMG revealed no significant decline in repetitive stimulation.Muscle biopsies of limb muscle were unremarkable.Creatine kinase and thyroid function test were in normal limits.MRI revealed unilateral.focal or difluse enlargement and enhancement of extraocular muscles,involving 1 extraocular muscle in 2 cases,2extraocular muscles in 2 cases,more extraocular muscles in 1 case.No evidence indicated bone destruction or cavernous sinus abnormalities.Five Cases showed improvement and remission after long-term administration of steroids.Conclusion Persistent and asymmetrical ophthalmoplegia is connnon in orbital myositis.Extraocular muscle swelling characterized the MRI changes.
ABSTRACT
A granulomatose de Wegener é descrita como uma tríade de lesões: granuloma necrosante do trato respiratório, vasculite disseminada e glomerulonefrite. Pode ocorrer de maneira sistêmica ou localizada. O envolvimento ocular e orbitário é comum em ambas as formas da doença, estando presente em 50 por cento dos casos. O exame anatomopatológico e o c-ANCA+ foram fundamentais no diagnóstico efetivo da granulomatose de Wegener a despeito do envolvimento sistêmico nos casos apresentados.
Wegener granulomatosis (WG) is characterized by a classic triad of granulomatous inflammation of the respiratory tract, necrotizing vasculitis and nephritis. The absence of renal disease defines a subset of " limited WG" . Approximately 50 percent of WG patients develop ophthalmic disease. The histopatological study and +c-ANCA were essential to make a definite diagnosis in these cases.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Granulomatosis with Polyangiitis/diagnosis , Antibodies, Antineutrophil Cytoplasmic/blood , Exophthalmos/etiology , Sinusitis/etiology , Granulomatosis with Polyangiitis/complicationsABSTRACT
Relato de caso de uma paciente com inflamação idiopática da órbita com extensão extra-orbital. Foi realizada biópsia para confirmar o diagnóstico e a tomografia computadorizada demonstrou o comprometimento extra-orbital do processo inflamatório. O tratamento foi feito com metotrexato e radioterapia.
The authors report a case of a patient with idiopathic orbital inflammation with extension beyond the orbit. Biopsy was performed to confirm the diagnosis of idiopathic orbital inflammation and computed tomography demonstrated the extraorbital extension. Treatment with methotrexate and radiotherapy was used.