A 74-year-old healthy woman came referred by her ophthalmologist for evaluation and treatment of painful red eye of approximately one month evolution.
She had no history of interest, except for uncomplicated cataract surgery (non-complicated stenosis) in the same patient about four months earlier.
The examination revealed a raised lesion in the superonasal limbus of the left eye (close to the surgical incision) associated with multiple corneal microinfilters, as well as deep conjunctival engorgement
Treatment was initiated with broad-spectrum antibiotic eye drops, instillations of autologous serum eye drops and medroxyprogesterone were added.
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Due to the poor response to treatment, several serological tests were requested (including biochemistry, blood count, acute phase reactants and markers of autoimmunity).
At the same time, treatment with systemic corticosteroids at a dose of 1 mg/kg was initiated. Additionally, a scleroconjunctival lesion was removed after resection of the adjacent conjunctiva, with subsequent implantation of an amniotic membrane.
The biopsy was diagnostic of necrotizing granulomatosis associated with hyperplasia of plasma cells without accompanying vasculitis.
Serological test results were normal.
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Considering the possibility of CIPN, it was decided to start treatment with Cyclosporine A (3 mg/kg/day) combined with oral corticosteroids (1 mg/kg/day), but it was decided to replace them eight weeks after its onset
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This therapeutic regimen gradually controlled the inflammatory process.
Seven months after the onset of symptoms, the patient remains asymptomatic and continues with treatment.
