Systemic Lupus Erythematous Associated Anterior Scleritis and Uveitis

A patient with a past medical history of ITP presented with recurrent episodes of red, painful eyes. Slit lamp exam was notable for sectoral injection without nodules that was tender to palpation and did not completely blanch with phenylephrine. A general laboratory workup was unremarkable. A thorough review of systems only revealed ITP and a remote history of a rash of unknown etiology. The patient was diagnosed with scleritis, and was started on topical FML as she was unable to tolerate PO NSAIDs and steroids. Patient continued to have monthly recurrences, even with topical treatment. The patient was lost to follow up for a few years, but over that course still had recurrent scleritis episodes. On repeat slit lamp evaluation, the patient was found to have chronic corneal nodules inferior-temporally, consistent with anterior uveitis. A repeat laboratory evaluation showed a positive ANA of 1:320 and a CRP of 9 mg/L. The patient was evaluated by rheumatology and nephrology, and the patient was diagnosed with Systemic Lupus Erythematous, which subsequently resulted in a diagnosis of SLE associated anterior scleritis and uveitis. The patient was started on mycophenolate and hydroxychloroquine, while being tapered off FML drops. On most recent examination, the patient has not had recurrent inflammation, scleritis, or anterior uveitis.

Presentation Date: 09/21/2023

Issue Date: 10/06/2023