Bilateral idiopathic orbital pseudotumour in a child: a case report
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CASE REPORT
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Bilateral idiopathic orbital pseudotumour in a child: a case report Fangyuan Chen, Junjie Tang and Qing Zhou*
Abstract Background: Idiopathic orbital pseudotumour is rare in children. We report a case of bilateral paediatric idiopathic orbital pseudotumour and review the characteristics of this case. Case presentation: A 14-year-old female patient presented at our Department of Pulmonary and Critical Care Medicine (PCCM) with complaints of recurrent severe cold and cough for 3 weeks, which had been treated with an intravenous antibiotic. Meanwhile, the patient developed swelling of both eyelids during the period of cold and cough, but her symptoms did not improve after the ocular administration of tobramycin dexamethasone eye drops. The patient was referred from the respiratory medicine ward to our department because of gradually worsening ocular pain, visual deterioration, increased intraocular pressure and serious nausea/vomiting within 24 h of hospitalization. The diagnosis of bilateral idiopathic orbital pseudotumour was made ultimately because of the course of the disease, exclusion of diagnoses such as bacterial ocular infection or malignant tumours and subsequent evidence from orbital magnetic resonance imaging (MRI). Favourable progress in the ocular tension and eyelid swelling was achieved through treatment with intravenous dexamethasone. The binocular intraocular pressure gradually declined to approximately 15 mmHg, and there was favourable progression in the patient’s vision to 20/40 in both eyes on the ninth day of hospitalization. Conclusions: Our patient developed rapidly progressive acute orbital signs and symptoms and anterior inflammation, such as pain, proptosis, limited ductions, periorbital oedema, chemosis, vision loss and high intraocular pressure. This case highlights that idiopathic orbital pseudotumour is an uncommon but important cause of acute orbital syndrome in children. Keywords: Bilateral, Idiopathic orbital pseudotumor, Paediatric, Case report
Background Idiopathic orbital pseudotumour (IOPT) was first described in 1905 by Birch-Hirschfeld who termed the condition orbital pseudotumor [1]. This term was used to describe orbital disease with an idiopathic cause, spontaneous resolution, and non-granulomatous changes on histopathology. While IOPT is well described among adults, it has a very low incidence in the paediatric population [1]. Therefore, little is known
about the clinical presentation, and early diagnosis is a challenge. Herein, we present a case of bilateral idiopathic orbital pseudotumour in a paediatric patient, referred from the Department of Pulmonary and Critical Care Medicine (PCCM) to our ward after a period of respiratory infection, who was diagnosed with the help of MRI and clinical characteristics, and successfully treated with intravenous corticosteroids.
* Correspondence: [email protected] The Department of Ophthalmology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu Avenue, Tianhe District of Guangzhou, Guangzhou
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