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Corneal chrysiasis. Gold salt deposits in the cornea in a patient with rheumatoid arthritis. An analysis with confocal microscopy
Crisiasis corneal. Depósitos corneales de sales de oro en paciente con artritis reumatoide. Análisis con microscopía confocal
E. Santos-Bueso
, M. Ahmed-Wasfy, F. Sáenz-Francés, J. Gil-de-Bernabé, J.M. Martínez-de-la-Casa, J.M. Benítez-del-Castillo, J. García-Feijoo
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Unidad de Neurooftalmología, Hospital Clínico San Carlos, Madrid, Spain
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An analysis with confocal microscopy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "237" "paginaFinal" => "239" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Santos-Bueso, M. Ahmed-Wasfy, F. Sáenz-Francés, J. Gil-de-Bernabé, J.M. Martínez-de-la-Casa, J.M. Benítez-del-Castillo, J. García-Feijoo" "autores" => array:7 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Santos-Bueso" "email" => array:1 [ 0 => "esbueso@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Ahmed-Wasfy" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Sáenz-Francés" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Gil-de-Bernabé" ] 4 => array:2 [ "nombre" => "J.M." "apellidos" => "Martínez-de-la-Casa" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Benítez-del-Castillo" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "García-Feijoo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Neurooftalmología, Hospital Clínico San Carlos, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Crisiasis corneal. Depósitos corneales de sales de oro en paciente con artritis reumatoide. Análisis con microscopía confocal" ] ] "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" => 1128 "Ancho" => 1499 "Tamanyo" => 227300 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Confocal microscope. Gold salt deposits in the superficial epithelium.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sodium aurothiomalate or gold salt (GS) is utilized to induce remission in rheumatoid arthritis (RA) although at present it has been displaced by methotrexate in low dosages as first choice drug.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">GS, administered intramuscularly at a maximum dosage of 1<span class="elsevierStyleHsp" style=""></span>g, can sediment in any bodily organ or system and therefore it is necessary to carry out regular analyses to identify side effects such as kidney, liver or hematopoietic insufficiency. Side effects arise in one-third of patients and could cause treatment suspension in 20% of cases.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This paper presents a case of a patient with RA treated with GS who exhibited corneal deposits of said drug and the results of corneal analysis with confocal microscope.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Case report</span><p id="par0020" class="elsevierStylePara elsevierViewall">A patient, age 60 with RA of 20 years evolution (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), in treatment with intramuscular GS (50<span class="elsevierStyleHsp" style=""></span>mg week the first 6 months and 50<span class="elsevierStyleHsp" style=""></span>mg per month for the past 7 years), referred with progressively diminishing eyesight in the past few months and the appearance of luminous halos. Visual acuity was of 0.6 in both eyes (BE) and slit lamp examination revealed deposits in the central stroma of BE comprising golden dispersed granular material without inflammatory reaction (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The rest of the anterior pole, intraocular pressure and ocular fundus were normal.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Corneal analysis was performed with confocal microscope (Confoscan model P4. Tomey AG, Erlangen-Tennenlohe, Germany) identifying dispersed shiny granules of homogeneous size and density in all layers of the cornea (<a class="elsevierStyleCrossRefs" href="#fig0015">Figs. 3–6</a>). The gold deposits were seen as shiny particles in variable shapes and sizes in all corneal layers and with higher density in the stroma (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>) and endothelium (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>) compared to the density found in the superficial epithelium (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and sub-basal layer (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The patient was referred to the Rheumatology Service for examination. It was decided not to carry out genetic study and GS was substituted by methotrexate. After 1, 2 and 3 years the patient remained stable without activity in RA and without changes in the GS deposits homogeneously distributed throughout the corneal layers and maintaining the same density (analyzed with confocal microscope).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Rheumatoid arthritis is considered to be the result of the action of an antigen in an individual with adequate genetic predisposition. It has been demonstrated that the presence of HLA-DR3 is related to the development of renal, cutaneous and hematological toxicity due to GS.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> In the instant case it was decided not to carry out a genetic study due to the evidence of the clinical condition, the stability of the RA process and the absence of complications derived from GS treatment.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The most frequent adverse ocular reaction of GS is deposits of the drug in the cornea, or corneal chrysiasis, which can occur in up to 40% of patients treated with this drug for long periods of time. The most frequent symptoms referred by patients are diminished vision or perception of luminous or colored halos.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The threshold dosage of GS which gives rise to corneal deposits is not known. When the aggregate GS dosage exceeds clearing capacity, the gold salt deposits in different areas of the body such as the cornea. Corneal GS deposits are dosage-dependent and reversible even though the elimination thereof is a slow process which can take up to 9 years after suspending treatment.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> Said deposits have been described in the corneal epithelium and stroma<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and in all corneal layers, predominantly in the anterior stroma,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> probably due to phagocytosis from the aqueous humor.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">This paper presents evidence of GS deposits in all corneal layers and predominantly in the corneal stroma and endothelium.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">No conflict of interest has been declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres273616" "titulo" => array:3 [ 0 => "Abstract" 1 => "Case report" 2 => "Discussion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec255619" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres273617" "titulo" => array:3 [ 0 => "Resumen" 1 => "Caso clínico" 2 => "Discusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec255620" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-05-31" "fechaAceptado" => "2012-09-06" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec255619" "palabras" => array:5 [ 0 => "Gold salts" 1 => "Cornea" 2 => "Chrysiasis" 3 => "Microscopy" 4 => "Confocal" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec255620" "palabras" => array:5 [ 0 => "Sales de oro" 1 => "Córnea" 2 => "Crisiasis" 3 => "Microscopía" 4 => "Confocal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Case report</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 60-year-old woman with rheumatoid arthritis of 20 years onset, on treatment with monthly intramuscular gold salts (GS) for the last 7 years. She complained of suffering from halo vision, and the examination showed a visual acuity of 0.6 in both eyes (BE). The slit lamp showed some deposits in the stroma with scattered golden granulated, without any further inflammatory reaction.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">GS deposits are dose-dependent and reversible, although very slowly. In this article, we introduce, for the first time, evidence of deposits of GS in all layers of the cornea, predominantly in the corneal stroma and in the endothelium.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mujer de 60 años de edad con artritis reumatoide de veinte años de evolución, en tratamiento con sales de oro (SO) intramusculares mensuales en los últimos 7 años. Refería visión de halos y presentaba una agudeza visual de 0,6 en ambos ojos (AO) y en la lámpara de hendidura destacaban depósitos en el estroma central de AO de material granulado dorado disperso y sin reacción inflamatoria. Se realizó estudio con microscopía confocal.</p> <span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los depósitos de SO son dosis-dependientes y reversibles aunque de forma muy lenta. En este trabajo se presenta por primera vez la evidencia de los depósitos de SO en todas las capas de la córnea, de predominio en el estroma y endotelio corneales.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santos-Bueso E, et al. Crisiasis corneal. Depósitos corneales de sales de oro en paciente con artritis reumatoide. Análisis con microscopía confocal. Arch Soc Esp Oftalmol. 2013;88:237–9.</p>" ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1125 "Ancho" => 1500 "Tamanyo" => 267473 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Symmetrical inflammation and deformities in the proximal inter-phalangeal and metacarpal–phalangeal joints.</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" => 2294 "Ancho" => 1500 "Tamanyo" => 398451 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Deposits in the central stroma of disperse golden granulated material without inflammatory reaction in both eyes.</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" => 1128 "Ancho" => 1499 "Tamanyo" => 227300 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Confocal microscope. Gold salt deposits in the superficial epithelium.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1125 "Ancho" => 1500 "Tamanyo" => 216278 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Confocal microscope. Sub-basal area showing gold salt deposits between the sub-basal nerves.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1127 "Ancho" => 1500 "Tamanyo" => 256810 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Confocal microscope. Gold salt deposits in the corneal stroma with greater density than in the superficial layers.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1127 "Ancho" => 1500 "Tamanyo" => 252921 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Confocal microscope. Gold salt deposits in the corneal endothelium with greater density than in superficial layers.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Harrison Principios de Medicina Interna, II" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.E. Lipsky" 1 => "K.F. Anbten" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:6 [ "edicion" => "18th ed." "fecha" => "2008" "paginaInicial" => "2738" "paginaFinal" => "2752" "editorial" => "McGraw-Hill" "editorialLocalizacion" => "Mexico, DF" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toxicidad ocular por fármacos y drogas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Díaz-Llopis" 1 => "J.M. Benítez del Castillo Sánchez" 2 => "J.I. Belda" 3 => "P.J. Morillas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "titulo" => "Manifestaciones oftalmológicas de las enfermedades generales. LXXVII ponencia de la Sociedad Española de Oftalmología" "paginaInicial" => "512" "serieFecha" => "2001" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Confocal microscopy in ocular chrysiasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Donate" 1 => "J.M. Benítez del Castillo" 2 => "C. Donate" 3 => "J. García Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cornea" "fecha" => "2003" "volumen" => "22" "paginaInicial" => "573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12883354" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular chrysiasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. McCormick" 1 => "A. di Bartolomeo" 2 => "V. Raju" 3 => "I. Schwab" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "1985" "volumen" => "92" "paginaInicial" => "1432" "paginaFinal" => "1435" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4069607" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corneal chrysiasis: in vivo confocal microscopy analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Paladini" 1 => "U. Menchini" 2 => "R. Mencucci" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Ophthalmol" "fecha" => "2010" "volumen" => "20" "paginaInicial" => "776" "paginaFinal" => "779" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20099230" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000008800000006/v1_201309060051/S2173579413000972/v1_201309060051/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000008800000006/v1_201309060051/S2173579413000972/v1_201309060051/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579413000972?idApp=UINPBA00004N" ]
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