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array:24 [ "pii" => "S2173579417300981" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.05.003" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1118" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:543-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669116302349" "issn" => "03656691" "doi" => "10.1016/j.oftal.2016.11.006" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1118" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:543-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 25 "formatos" => array:2 [ "HTML" => 21 "PDF" => 4 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "543" "paginaFinal" => "546" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Granulomatosis with polyangiitis confined to lacrimal gland, a case report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1312 "Ancho" => 1500 "Tamanyo" => 539275 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A) Visión macroscópica de la lesión extirpada, muestra tumoración café grisácea de 26<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>21<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>11<span class="elsevierStyleHsp" style=""></span>mm, de bordes irregulares. B) Fotomicrografía (H&E, ×10) muestra vasos sanguíneos de pequeño calibre con inflamación de sus paredes y obliteración de sus luces que alternan con zonas de necrosis coagulativa de distribución geográfica y con cúmulos de infiltrado inflamatorio mononuclear. C) Fotomicrografía (H&E, ×10) que muestra entre acinos y conductos de la glándula lagrimal un vaso sanguíneo de pequeño calibre con necrosis de su pared rodeado por inflamación granulomatosa. D) Fotomicrografía (H&E, ×40) que muestra vaso sanguíneo de pequeño calibre con necrosis fibrinoide de su pared (asterisco) y obliteración parcial de su luz (flecha), rodeado por infiltrado inflamatorio de linfocitos, células epitelioides y gigantes multinucleadas (cabeza de flecha).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Zuazo, M. González, A. Abdala, O. Olvera-Morales, M.H. Monroy, A. Rodríguez-Reyes, J.L. Tovilla-Canales, Á. Nava-Castañeda" "autores" => array:8 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Zuazo" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "González" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Abdala" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Olvera-Morales" ] 4 => array:2 [ "nombre" => "M.H." "apellidos" => "Monroy" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Reyes" ] 6 => array:2 [ "nombre" => "J.L." "apellidos" => "Tovilla-Canales" ] 7 => array:2 [ "nombre" => "Á." "apellidos" => "Nava-Castañeda" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579417300981" "doi" => "10.1016/j.oftale.2017.05.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417300981?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116302349?idApp=UINPBA00004N" "url" => "/03656691/0000009200000011/v1_201710270123/S0365669116302349/v1_201710270123/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S217357941730097X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.05.002" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1117" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:547-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Eyelid metastasis as first presentation of renal cell carcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "547" "paginaFinal" => "551" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis palpebral como primera manifestación de un tumor renal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1792 "Ancho" => 1600 "Tamanyo" => 966139 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemical tests (400×) were positive for: (a) vimentin; (b) CD10; (c) EMA; (d) CAM 5.2; (e) AE1/AE3; (f) the tumor was negative for actine although the marker enabled the identification of blood vessels.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Cabrera-Beyrouti, E. Campos-Mollo, E. Rico-Santos, D.N. Jiménez-Rodríguez, M. Lledó-Riquelme, J. Vierna-García" "autores" => array:6 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Cabrera-Beyrouti" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Campos-Mollo" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Rico-Santos" ] 3 => array:2 [ "nombre" => "D.N." "apellidos" => "Jiménez-Rodríguez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Lledó-Riquelme" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Vierna-García" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669116302337" "doi" => "10.1016/j.oftal.2016.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669116302337?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941730097X?idApp=UINPBA00004N" "url" => "/21735794/0000009200000011/v1_201710301214/S217357941730097X/v1_201710301214/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579417301093" "issn" => "21735794" "doi" => "10.1016/j.oftale.2017.03.021" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1185" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2017;92:539-42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Interferon alpha-2a as alternative treatment for conjunctival squamous cell carcinoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "539" "paginaFinal" => "542" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Interferón alfa-2a como tratamiento alternativo para el carcinoma conjuntival de células escamosas" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3292 "Ancho" => 2745 "Tamanyo" => 1703196 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical photographs of patient with conjunctival lesion in LE and strabismus in RE. (B) histopathology shows infiltrating epithelial neoplasia with keratin spheres and areas of necrosis. Details show intercellular joins, characteristic of CSCC with atypical mitosis (hematoxylin-eosine, 10× and 40×). (C) Extension of CSCC in LE prior to treatment. (D) Annual checkup at the end of treatment with IFN alpha-2a, showing clinical absence of malign neoplasia.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Cruzado-Sánchez, M. Salas-Diaz, W.A. Tellez, S.E. Alvarez-Matos, S. Serpa-Frías" "autores" => array:5 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Cruzado-Sánchez" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Salas-Diaz" ] 2 => array:2 [ "nombre" => "W.A." "apellidos" => "Tellez" ] 3 => array:2 [ "nombre" => "S.E." "apellidos" => "Alvarez-Matos" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Serpa-Frías" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669117301259" "doi" => "10.1016/j.oftal.2017.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669117301259?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579417301093?idApp=UINPBA00004N" "url" => "/21735794/0000009200000011/v1_201710301214/S2173579417301093/v1_201710301214/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Granulomatosis with polyangiitis confined to lacrimal gland, a case report" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "543" "paginaFinal" => "546" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Zuazo, M. González, A. Abdala, O. Olvera-Morales, M.H. Monroy, A. Rodríguez-Reyes, J.L. Tovilla-Canales, Á. Nava-Castañeda" "autores" => array:8 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Zuazo" "email" => array:1 [ 0 => "franzuazo@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Abdala" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "O." "apellidos" => "Olvera-Morales" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "M.H." "apellidos" => "Monroy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "A." "apellidos" => "Rodríguez-Reyes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "J.L." "apellidos" => "Tovilla-Canales" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Á." "apellidos" => "Nava-Castañeda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Instituto de Oftalmología «Fundación de Asistencia Privada Conde de Valenciana IAP», Mexico City, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Patología Oftálmica, Asociación para Evitar la Ceguera en México IAP, Hospital «Dr. Luis Sánchez Bulnes» , Mexico City, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 526 "Ancho" => 1500 "Tamanyo" => 97915 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Computerized tomography with soft tissue window: (A) coronal section: left superotemporal lesion, with inferomedial ocular globe displacement causing indentation thereof. (B) Axial section, showing left a lesion between ocular globe and lateral rectus, producing proptosis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Wegener's granulomatosis, currently known as granulomatosis with polyangiitis (GP), is one of the positive vasculitis for the most common anti-neutrophile cytoplasmic antibodies (ANCA). It compromises the high and low airwaves in 95% and the renal system in 75%. However, during its clinical course it can compromise any organ.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a> Occasionally, the lacrimal gland can be affected in isolation and become the initial expression of the disease.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,3</span></a> The purpose of the present article is to describe one case of GP localized in the lacrimal gland.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinical case</span><p id="par0010" class="elsevierStylePara elsevierViewall">Female, 43, with a history of arterial hypertension and depressive syndrome, who consulted due to rapidly progressing and painful volume increase in the left periorbitary region, with upper eyelid reddening and 4 months evolution. Uncorrected visual acuity (UVA) was 20/20 in each eye, isochoric pupils with normal reaction. Intraocular pressure was 11<span class="elsevierStyleHsp" style=""></span>mmHg in each eye. Ocular motility revealed a deficit of −3 for the left eye (LE) elevation and −2 for LE abduction, LE inferior displacement and proptosis of 3<span class="elsevierStyleHsp" style=""></span>mm. The upper left eyelid exhibited increased volume, erythematous and edematous appearance, indurated and painful to the touch (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No alterations were found in the anterior and posterior segments of both eyes.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Computerized tomography (CT) showed an oval-shaped tumor having a diameter of 24<span class="elsevierStyleHsp" style=""></span>mm in the superotemporal quadrant with well defined edges and moderate enhancements with contrast and without changes in the adjacent bone (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Excisional biopsy was performed with anterior and lateral orbitotomy, obtaining a mass measuring 26<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>21<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>11<span class="elsevierStyleHsp" style=""></span>mm with multilobulated surface, poorly defined edges and grayish coffee color (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">At the histological level, the normal lobular architecture of the lacrimal gland was lost and acinus and ducts were diminished. Some small vessels showed transmural fibrinogen necrosis, in addition to the presence of lymphocytic inflammatory infiltrates, plasma cells, neutrophiles, large areas of patch necrobiosis surrounded by inflammatory infiltrate aggregates comprising lymphocytes, plasma cells, epitheloid histiocytes and multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B–D). These findings suggested the diagnostic of vasculitis of the granulomatosis type with polyangiitis in active phase.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patient evolved positively after surgery. UVA remained at 20/20 in both eyes with discrete upper left lateral eyelid ptosis without compromising the visual axis. LE motility exhibited a deficit of −2 with elevation and −1 with abduction. The histopathological diagnostic prompted questions to the patient who denied other systemic symptoms. Thorax and paranasal cavities tomography and encephalus nuclear magnetic resonance did not reveal alterations. Blood biometry and renal function were within normal limits. cANCA and pANCA were negative.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Due to the localized presence of GP without systemic compromise, it was decided not to initiate immunomodulating treatment for the time being and maintain the patient in follow-up. At present the patient remains stable without systemic symptoms, blood biometry and kidney function within normal limits and negative antibodies 12 months after diagnostic.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">In 95% of patients, the initial symptom of GP presents in head and neck.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">4</span></a> Orbit compromise occurs in up to 60% of cases and could potentially entail visual loss and facial deformation.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,4</span></a> This could present with proptosis in 69% of cases,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> ocular inflammation, orbit wall loss in 38% of cases,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a> epiphora in 52%,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> diplopia in 52%, palpebral edema and erythema in 31%, orbit pain in 24%, diminished VA in 17%,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> sinus compromise and loss of the nasal <span class="elsevierStyleItalic">septum</span>. Lacrimal gland compromise is rare, generally unilateral and initially expresses with increased size (inflammatory dachryoadenitis).<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Serological tests are generally negative both in the initial stages as well as in the localized forms of the disease. Accordingly, 90% of patients with generalized GP exhibit positive ANCA but only 47% present localized forms thereof.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,6</span></a> This increases the difficulty in diagnosing localized GP.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Imaging findings are not specific for GP and could be found in other orbit inflammatory processes. This underscores the importance of biopsy for obtaining a definitive histopathological diagnosis.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Histopathological findings include granulomatous or non-granulomatous vasculitis, fatty tissue necrosis, combination of acute and chronic granulomatous or non-granulomatous inflammation, geographic fibrinoid degeneration and micro-abscesses.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> In patients with GP limited to the orbit, the classic triad of vasculitis, tissue necrosis and granulomatous inflammation is observed in only 25–54% of orbit biopsies,<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,7,8</span></a> in comparison with 91% of lung biopsies in patients with GP who exhibit said triad.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">7,9</span></a> Due to the high histopathological variability that can be found in orbitary GP, diagnostic requires clinic and pathological correlation. For this reason, when GP is suspected, ANCA serology is suggested together with investigation of alterations in the kidneys, the upper and lower pathways as well as imaging studies.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres933125" "titulo" => "Abstract" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec907503" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres933124" "titulo" => "Resumen" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec907504" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-09-02" "fechaAceptado" => "2016-11-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec907503" "palabras" => array:3 [ 0 => "Granulomatosis with polyangiitis" 1 => "Necrotizing vasculitis" 2 => "Anti-neutrophil cytoplasm antibody" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec907504" "palabras" => array:3 [ 0 => "Granulomatosis con poliangeítis" 1 => "Vasculitis necrotizante" 2 => "Anticuerpo anti-citoplasma de neutrófilos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 43 year-old woman consulted due to 2 months of swelling on the superolateral side of the left orbit, with pain and erythema. An excisional biopsy was performed that revealed vasculitis with polyangiitis of the lacrimal gland. A systemic study showed that no other system was compromised.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Orbital involvement occurs in up to 60% of patients with granulomatosis with polyangiitis. The involvement of the lacrimal gland is rare and often unilateral. Serological tests are generally negative, both in initial stages, as in localized forms of the disease.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Discussion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mujer de 43 años, consulta por aumento de volumen orbitario superolateral izquierdo, doloroso, eritematoso de 2 meses de evolución. Se realiza biopsia escisional revelando vasculitis con poliangeítis de glándula lagrimal. El estudio sistémico no reveló compromiso de otros órganos.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El compromiso orbitario ocurre hasta en el 60% de los pacientes con granulomatosis con poliangeítis. La afección de la glándula lagrimal es rara, y frecuentemente unilateral. Las pruebas serológicas generalmente son negativas, tanto en etapas iniciales, como en las formas localizadas de la enfermedad.</p></span>" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "abst0015" "titulo" => "Caso clínico" ] 1 => array:2 [ "identificador" => "abst0020" "titulo" => "Discusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Zuazo F, González M, Abdala A, Olvera-Morales O, Monroy MH, Rodríguez-Reyes A, et al. Granulomatosis con poliangeítis localizado en la glándula lagrimal, a propósito de un caso. Arch Soc Esp Oftalmol. 2017;92:543–546.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 324 "Ancho" => 1476 "Tamanyo" => 69712 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Clinic photograph: (A) inferior and medial displacement of the left ocular globe, with erythema and increased superotemporal volume; (B) unaltered RE ocular motility with LE elevation deficit and abduction.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 526 "Ancho" => 1500 "Tamanyo" => 97915 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Computerized tomography with soft tissue window: (A) coronal section: left superotemporal lesion, with inferomedial ocular globe displacement causing indentation thereof. (B) Axial section, showing left a lesion between ocular globe and lateral rectus, producing proptosis.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1312 "Ancho" => 1500 "Tamanyo" => 539275 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">(A) Macroscopic view of the extirpated lesion, showing irregular shaped grayish dark brown tumor measuring 26<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>21<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>11<span class="elsevierStyleHsp" style=""></span>mm. (B) Photomicrography (H&E, 10×) showing small gauge blood vessels with inflamed walls and obliteration of patency alternating with geographically distributed coagulation necrosis areas with mononuclear inflammatory infiltrate aggregates. (C) Photomicrography (H&E, 10×) showing between lacrimal gland acines and ducts a small gauge blood vessel with necrosis on walls, surrounded by granulomatous inflammation. (D) Photomicrography (H&E, 40×) showing small gauge blood vessel with fibrinogen necrosis on walls (asterisk) and partial patency obliteration (arrow), surrounded by inflammatory infiltrate of lymphocytes, epitheloid and giant multinucleated cells (arrowhead).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and imaging features of lacrimal gland involvement in granulomatosis with polyangiitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.T. Tan" 1 => "I. Davagnanam" 2 => "H. Isa" 3 => "G.E. Rose" 4 => "D.H. Verity" 5 => "C.D. 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