Rituximab in rheumatoid arthritis-associated peripheral ulcerative keratitis

Abstract

Clinical case

We report two cases of patients affected by longstanding rheumatoid arthritis who developed a severe form of peripheral ulcerative keratitis (PUK). Neither of them had an optimal biological and clinical control of their systemic illness despite being treated with several disease-modifying antirheumatic drugs (DMARDs) and biologic therapy. Highdose systemic corticosteroids were given to treat the PUK without any success. Rituximab resulted in a favourable response with resolution of the corneal lesions and optimal control of their systemic illness.

Discussion

Rituximab may be an additional tool to arrest progressive rheumatoid arthritisassociated PUK that is refractory to other drugs.

Resumen

Caso clínico

Se presentan dos pacientes diagnosticadas de artritis reumatoide de larga evolución que desarrollaron una queratitis ulcerativa periférica (QUP) grave. Habían sido tratadas previamente con fármacos modificadores de la enfermedad (FAME) y terapia biológica (TB) sin alcanzar un control clínico-biológico óptimo de su enfermedad. Se trataron inicialmente con corticoides sistémicos a dosis altas sin éxito. Rituximab indujo la regresión de las lesiones corneales y el control de su artritis reumatoidea.

Discusión

Rituximab puede ser una alternativa para detener la progresión de la QUP asociada a artritis reumatoide refractaria a otros fármacos.