Format

Send to

Choose Destination
Rev Med Interne. 2018 Sep;39(9):711-720. doi: 10.1016/j.revmed.2018.02.001. Epub 2018 Feb 26.

[Scleritis and systemic diseases: What should know the internist?]

[Article in French]

Author information

1
Service de médecine interne et maladies systémiques, médecine interne 2, CHU Dijon-Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France. Electronic address: philip.bielefeld@chu-dijon.fr.
2
Service de médecine interne, DHU I2B, inflammation, immunopathology, biotherapy, centre national de référence des maladies auto-immunes et systémiques rares, hôpital Pitié-Salpêtrière, université Pierre-et-Marie-Curie-Paris 6, AP-HP, 75013 Paris, France. Electronic address: david.saadoun@aphp.fr.
3
Service de médecine interne, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75571 Paris cedex 12, France. Electronic address: heron@quinze-vingts.fr.
4
Service de médecine interne, hôpital Avicenne, AP-HP, université Paris 13, Sorbonne Paris Cité, 93009 Bobigny cedex, France. Electronic address: sebastien.abad@aphp.fr.
5
Service de médecine interne et maladies systémiques, médecine interne 2, CHU Dijon-Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France. Electronic address: herve.devillers@u-bourgogne.fr.
6
Service d'ophtalmologie, CHU Dijon-Bourgogne, 14, rue Paul-Gaffarel, 21079 Dijon cedex, France. Electronic address: clemence.deschasse@chu-lyon.fr.
7
Service de médecine interne, hôpital Ambroise-Paré, AP-HP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France. Electronic address: salim.trad@aphp.fr.
8
Service de médecine interne, GH Saint-Louis-Lariboisière-Fernand-Widal, hôpital Lariboisère, AP-HP, université Sorbonne Paris Cité Paris Diderot, 75475 Paris cedex 10, France. Electronic address: damien.sene@aphp.fr.
9
Service de médecine interne et immunologie clinique, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: gilles.kaplanski@ap-hm.fr.
10
Service de médecine interne, hospices civils de Lyon, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université de Lyon, 69100 Lyon, France. Electronic address: Pascal.seve@chu-lyon.fr.

Abstract

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.

KEYWORDS:

Auto-immune disease; Maladie auto-immune; Maladie systémique; Scleritis; Sclérite; Systemic disease; Traitement; Treatment; Vascularite; Vasculitis

PMID:
29496270
DOI:
10.1016/j.revmed.2018.02.001
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center