May 2003
Volume 44, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2003
Conjunctival Nodules Associated with Rheumatoid Arthritis ("Rheumatoid Nodulosis"): A Clinicopathologic Study of Two Cases
Author Affiliations & Notes
  • B.J. Fredrickson
    Ophthalmology, Baylor College of Medicine, Houston, TX, United States
  • P. Chevez-Barrios
    Pathology and Ophthalmology, Baylor College of Medicine, Houston, TX, United States
  • A.Y. Matoba
    Pathology and Ophthalmology, Baylor College of Medicine, Houston, TX, United States
  • S.C. Pflugfelder
    Pathology and Ophthalmology, Baylor College of Medicine, Houston, TX, United States
  • R.L. Font
    Pathology and Ophthalmology, Baylor College of Medicine, Houston, TX, United States
  • Footnotes
    Commercial Relationships  B.J. Fredrickson, None; P. Chevez-Barrios, None; A.Y. Matoba, None; S.C. Pflugfelder, None; R.L. Font, None.
  • Footnotes
    Support  Retina Research Foundation, Houston, TX; Research to Prevent Blindness, New York, NY
Investigative Ophthalmology & Visual Science May 2003, Vol.44, 2447. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      B.J. Fredrickson, P. Chevez-Barrios, A.Y. Matoba, S.C. Pflugfelder, R.L. Font; Conjunctival Nodules Associated with Rheumatoid Arthritis ("Rheumatoid Nodulosis"): A Clinicopathologic Study of Two Cases . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2447.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Abstract: : Purpose: To describe the clinical and histopathologic features of rheumatoid nodules in the conjunctiva. Methods: Biopsies were taken from large conjunctival nodules in two patients with rheumatoid arthritis being treated with methotrexate. One of these patients had a history of chronic follicular conjunctivitis. Histopathologic features of these lesions were compared with those of classic, subcutaneous rheumatoid nodules and ocular rheumatoid nodules, including the one previous case report of conjunctival rheumatoid nodules. Results: Biopsies of the lesions showed chronic inflammation in the conjunctiva composed mainly of plasma cells surrounded by foci of granulomatous inflammation. The granulomas exhibit areas of central necrobiosis of collagen surrounded by a palisade of epithelioid histiocytes and fibroblasts. The collective findings are consistent with rheumatoid nodules of the conjunctiva. Interestingly, both patients were receiving methotrexate treatment for control of their rheumatoid arthritis. Accelerated rheumatoid nodulosis is a well known complication of methotrexate use. Methotrexate-induced accelerated nodulosis most commonly involves the fingers. Involvement of the elbows, knees, feet, lungs, larynx and heart also has been documented. Methotrexate-induced accelerated nodulosis of the ocular surface has not been previously reported. Conclusions: Rheumatoid nodules can develop in the conjunctiva of patients with rheumatoid arthritis and have the appearance of a chronic follicular conjunctivitis. Methotrexate therapy may be a risk factor for this condition.

Keywords: conjunctiva • autoimmune disease • pathology: human 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×