Purpose@#We
report a case of stromal
keratitis in a
patient with
congenital hypogammaglobulinemia.Case
summary:
A 15-year-old boy presented with decreased
visual acuity in the right
eye. He had been diagnosed with
congenital hypogammaglobulinemia at about 16 months of age and had received regular doses of
intravenous immunoglobulin. The best-corrected
visual acuity of the right
eye was 0.02 and the
intraocular pressure 11 mmHg. On anterior segment examination, thinning combined with stromal infiltration of the paracentral
cornea was evident, but no epithelial defect was apparent. We scheduled detailed systemic examinations and
laboratory investigations to rule out infectious
keratitis. His
serum immunoglubulin G (
IgG) level was 328.9 mg/dL, thus less than that 3 months priorly (434.8 mg/dL). The lesion did not improve after
prescription of topical
antibiotics and
steroid. The
serum IgG level gradually increased to 394.4 mg/dL after
immunoglobulin administration, and the corneal infiltration gradually decreased. After 5 months of
treatment, the
serum IgG levels ranged between 480 and 530 mg/dL; we noted no
recurrence or worsening of the corneal lesion. @*Conclusions@#We
report a case of stromal
keratitis in a
patient with
congenital hypogammaglobulinemia; we prescribed
intravenous immunoglobulin.