case_images: PMC4573197_01
case_images: Clinical picture and H & E staining.. Notes: (A and B) Showing restriction of down gaze in right eye (A) and right orbital fullness (B). (C) Renal biopsy revealed increased endocapillary cellularity (yellow arrow), cellular crescent (black arrow), and chronic interstitial inflammation (red arrow); (H&E 10x).. Abbreviation: H&E, hematoxylin and eosin.
case_images: imcrj-8-181Fig1.jpg
case_images: PMC4573197_01_imcrj-8-181Fig1.jpg
case_images: f1-imcrj-8-181
case_images: Hg in both eyes. Horizontal eye movements were full, except for painful restriction of up and down gaze of the right eye (Figure 1B). External examination revealed right superior orbital fullness (Figure 1A) with mild tenderness on palpation. Diagnosis of SLE was confirmed on hematological examination (ANA [antinuclear antibody], anti-Smith antibody and anti-ds DNA were positive) and renal biopsy (Figure 1C) showing histopathological/immunological changes of SLE (granular membranous and mesangial deposits [2+ to 3+] of IgG, IgA, IgM, C3, and C1q).
case_images: MRI of orbits.. Notes: (A and B) Showing coronal section (T1 and T2) at initial presentation. White arrow pointing SOVT in right eye. (C and D) Showing MRI of orbit 4 weeks later; coronal section (T1 and T2). White arrow pointing to resolving superior ophthalmic vein thrombosis in right eye. Red arrow pointing to new SOVT in left eye.. Abbreviation: SOVT, superior ophthalmic vein thrombosis; MRI, magnetic resonance imaging.
case_images: imcrj-8-181Fig2.jpg
case_images: PMC4573197_01_imcrj-8-181Fig2.jpg
case_images: f2-imcrj-8-181
case_images: MRI of the orbits confirmed thrombosis of the right SOV without extension into the cavernous sinus (Figure 2A and B). Sequential MRI at 1 month showed interval improvement of the right SOVT and a new thrombosis in the left SOV (Figure 2C and D).