Infliximab for progressive peripheral ulcerative keratitis in a patient with juvenile rheumatoid arthritis.

摘要

Peripheral ulcerative keratitis (PUK) is a progressive thinning of the peripheral cornea associated with inflammation. Although sterile PUK in adults often presents in systemic autoimmune diseases such as rheumatoid arthritis (RA),1 PUK has been rarely reported as a complication of juvenile rheumatoid arthritis (JRA).Infliximab is a chimeric antibody against the proinflam-matory cytokine tumor necrosis factor a, which stimulates the production of matrix metalloproteinases responsible for corneal stromal lysis in PUK.2 Whereas several studies have demonstrated that infliximab is effective in RA-associated PUK,1 there is no report on the use of infliximab for JRA-associated PUK. We herein report an 11-year-old girl with JRA who presented with rapidly progressive corneal ulcer-ation and scleritis despite the use of conventional immuno-suppressants. Corneal ulceration eventually stopped after treatment with infliximab.