Letter to the editor: orbital compartment syndrome as the first manifestation of SLE
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LETTER TO THE EDITOR
Letter to the editor: orbital compartment syndrome as the first manifestation of SLE Maria Colon 1
&
Lara El Khoury 2
Received: 14 September 2020 / Revised: 27 September 2020 / Accepted: 29 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
Dear Editor, We would like to express our deepest gratitude to Dr. Otto J. Hernandez Fustes for his insightful commentary on our case regarding orbital compartment syndrome as the initial manifestation of SLE [1]. SLE is a multisystemic disease with myositis being an uncommon manifestation, as reported in prior retrospective studies, with a prevalence of only 3% [2]. Orbital myositis commonly presents both acutely and unilaterally. The exact pathophysiology for unilateral presentation has yet to be established. While MRI remains the most sensitive imaging modality for diagnosis [3], the decision to perform CT of the orbits for our patient was based on practicality of the study given the urgency of clinical presentation. Myositis with orbital compartment syndrome is mainly a clinical diagnosis, and further imaging studies should not delay treatment as it is critical for the preservation of vision. The patient in our report responded well to the initial management with prednisone and mycophenolate mofetil. He remained in remission for about a year, however, developed
* Maria Colon [email protected] Lara El Khoury [email protected] 1
Department of Internal Medicine, Northwell Health, LIJ Forest Hills Hospital, Forest Hills, NY, USA
2
Division of Rheumatology, Northwell Health, NSUH/LIJ Medical Center, Manhasset, NY, USA
a mild flare of orbital myositis which resolved after a short course of prednisone.
Compliance with ethical standards Disclosures None.
References 1.
2.
3.
Hernandez Fustes OJ (2020) Comment “orbital compartment syndrome as the first manifestation of SLE”. Clin Rheumatol 1006710067. https://doi.org/10.1007/s10067-020-05250-w Maazoun F, Frikha F, Snoussi M, Kaddour N, Masmoudi H, Bahloul Z (2011) Systemic lupus erythematosusmyositis overlap syndrome: report of 6 cases. Clin Pract 1:89 Montagnese F, Wenninger S, Schoser B (2016) “Orbiting around” the orbital myositis: clinical features, differential diagnosis and therapy. J Neurol. Springer Berlin Heidelberg 263:631–640
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