Artrite reumatoide é uma doença autoimune de longa duração que provoca dor e inflamação nas articulações sinoviais. A dor e rigidez muitas vezes agravam-se a seguir ao descanso. É mais comum nas articulações do pulso e das mãos, afetando geralmente as mesmas articulações dos dois lados do corpo. A doença pode também afetar outras partes do corpo e causar diminuição do número de glóbulos vermelhos, inflamação à volta dos pulmões e inflamação à volta do coração. Pode também verificar-se febre e falta de energia. Muitas vezes os sintomas começam-se a manifestar gradualmente ao longo de semanas ou meses.
Introdução
O que você precisa saber de cara
Inflamação grave da esclera, frequentemente causada por bactérias, fungos ou vírus, levando a dor intensa, vermelhidão e possível perda visual. O diagnóstico precoce e tratamento agressivo com antibióticos ou antifúngicos são cruciais.
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Nenhum gene associado encontrado
Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Esclerite infecciosa
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Ensaios clínicos abertos e novidades científicas recentes
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Pesquisa e ensaios clínicos
1 ensaios clínicos encontrados.
Publicações mais relevantes
Systemic immunosuppressive therapy in idiopathic non-infectious uveitis and scleritis: disease remission, discontinuation, and relapse patterns.
Immunosuppressive therapy (IST) is indicated in idiopathic non-infectious uveitis and scleritis when local or topical treatments are insufficient, but long-term outcomes and predictors of relapse remain incompletely defined. We retrospectively reviewed clinical records of 110 patients with non-infectious uveitis or scleritis in the absence of systemic manifestation of disease who received IST. Time to remission, treatment duration, and relapse after IST withdrawal were analyzed by anatomic subtype. Predictors of remission and relapse were assessed using multivariable Cox and logistic regression models. Median follow-up was 84 months (IQR 48-135). Most patients achieved remission with first-line IST (79%), Methotrexate predominated in anterior (n = 27, 90%), intermediate (n = 13, 93%), and scleritis (n = 11, 85%), whereas cyclosporine was preferred in posterior (n = 20, 65%) and panuveitis (n = 12, 54%). Biological therapy (adalimumab) was used infrequently (n = 8, 7%). Median time to remission was 7 months (IQR 3.1-12.5), although posterior uveitis required significantly longer to remit (median 11 months; HR = 0.45 vs. AU, p = 0.005). Need for concomitant low-dose corticosteroids (≤10 mg/day) to achieve remission was associated with delayed remission (HR = 0.55, p = 0.006). IST was discontinued in 47% of patients, most commonly after ≥ 2 years due to disease control, while early discontinuation (< 2 years) was primarily due to adverse effects. Relapse occurred in 27% after withdrawal, typically within 10 months. Univariate analysis suggested differences by subtype, but only longer time to remission (p = 0.018) and shorter IST duration (p < 0.05) independently predicted relapse in multivariable models. IST effectively induced remission and reduced relapse rates in ocular-only non-infectious inflammation. Achieving early control (within six months) and maintaining IST for at least two years were associated with more durable remission. Posterior involvement and the need for concomitant low-dose oral corticosteroids reflected greater disease severity, whereas delayed remission and shorter IST duration independently predicted relapse.
Chronic necrotizing sclerouveitis caused by Alternaria doliconidium.
PurposeTo report a case of fungal sclerouveitis caused by Alternaria doliconidium, misdiagnosed as autoimmune scleritis and incorrectly treated with immunosuppressive therapy.ObservationsA 69-year-old man presented with progressive chronic necrotizing scleritis in his right eye following ocular trauma. Initial treatment with antimicrobial and steroid therapy showed no improvement, and a scleral biopsy yielded inconclusive results. Autoimmune scleritis was suspected, leading to treatment with systemic steroids and immunosuppressants. Upon further examination, nodular necrotizing scleritis with scleral translucency and whitish floccules in the anterior chamber was observed, prompting a suspicion of fungal etiology. Molecular analysis via PCR confirmed the presence of Alternaria doliconidium.Conclusions and ImportanceThis case underscores the importance of considering fungal pathogens in cases unresponsive to conventional treatment and the critical role of advanced molecular diagnostics. This is the first reported case of sclerouveitis caused by Alternaria doliconidium, expanding the spectrum of ocular infections associated with this genus.
Long-Term Outcomes of 4-Point Expanded Polytetrafluoroethylene and 2-Point Polypropylene Fixation of Scleral-Sutured Intraocular Lenses.
Purpose: To compare the long-term outcomes of scleral-sutured intraocular lens (IOL) fixation using expanded polytetrafluoroethylene vs polypropylene sutures, with a focus on suture-related complications. Methods: A retrospective comparative review was conducted of 102 patients who underwent scleral-sutured IOL fixation between 2015 and 2019. Forty-eight eyes of 48 patients received 4-point fixation with expanded polytetrafluoroethylene sutures, and 55 eyes of 54 patients received 2-point fixation with polypropylene sutures. Postoperative complications, visual outcomes, and risk factors for suture-related complications were analyzed over a minimum follow-up of 5 years. Results: No instances of suture breakage were observed in either group over an average follow-up of 6.7 years. Suture exposure rates were 10.4% (5/48) for expanded polytetrafluoroethylene and 18.2% (10/55) for polypropylene (P = .27). The mean time to suture exposure was 2.7 ± 3.3 years in the expanded polytetrafluoroethylene group and 2.9 ± 2.5 years in the polypropylene group (P = .88). Mean logMAR visual acuity at final follow-up was 1.0 ± 1.2 in the expanded polytetrafluoroethylene group and 1.5 ± 1.2 in the polypropylene group (P = .06). The only significant risk factor for suture exposure was concurrent corneal transplantation or glaucoma surgery (odds ratio [OR], 9.3; P = .003). Surgical correction was required in all cases of exposure with expanded polytetrafluoroethylene sutures and in 2 cases with polypropylene sutures. One case of suture-associated infectious scleritis with endophthalmitis occurred in the expanded polytetrafluoroethylene group, and 1 case of endophthalmitis related to an explanted corneal graft occurred in the polypropylene group. Conclusions: Both expanded polytetrafluoroethylene and polypropylene sutures demonstrated durable outcomes with similar complication rates. Suture breakage was not observed in either group, and there were no differences in suture exposure rates between the 2 groups. Risk factors for suture exposure included the performance of a concurrent procedure.
Scleritis Secondary to Eosinophilic Granulomatosis With Polyangiitis.
Purpose: To describe a case of severe scleritis with uveitis as the initial presentation of underlying eosinophilic granulomatosis with polyangiitis. Methods: Case report from a university ophthalmology clinic describing ocular findings, diagnostic workup, and treatment for a 75-year-old woman presenting with severe anterior scleritis and panuveitis. Results: The patient was initially misdiagnosed and treated for presumed infectious scleritis for 1 month without improvement. Further workup revealed elevated perinuclear anti-neutrophil cytoplasmic antibodies, supporting a diagnosis of eosinophilic granulomatosis with polyangiitis. Prompt initiation of high-dose oral corticosteroids led to rapid resolution of ocular inflammation. Conclusions: Severe scleritis with uveitis can be the first manifestation of occult eosinophilic granulomatosis with polyangiitis. A high index of suspicion for underlying autoimmune disease and timely rheumatologic workup are essential for accurate diagnosis. Early systemic immunosuppressive therapy is critical to optimize visual outcomes and prevent irreversible ocular damage.
A Rare Case of Pseudomonas aeruginosa Keratoscleritis: Highlighting Early Diagnosis and Aggressive Treatment.
Pseudomonas aeruginosa keratoscleritis (PAK) is an uncommon but aggressive ocular infection that can rapidly threaten vision if not recognized and treated promptly. A 75‑year‑old woman presented with a large corneal epithelial defect, stromal infiltrates, and hypopyon. She was initially managed empirically for fungal keratitis but later diagnosed with PAK following scleral nodule excision and positive cultures for Pseudomonas aeruginosa (P. aeruginosa). Intensive therapy, including topical and systemic antibiotics, subconjunctival injections, and autologous serum tears, gradually improved corneal ulceration and scleritis. Although her visual acuity remained severely impaired, early initiation of targeted antimicrobial therapy preserved ocular integrity and avoided surgical intervention. PAK is a rare, sight-threatening infection with high morbidity if treatment is delayed. This case highlights the importance of early and accurate diagnosis, together with prompt and aggressive antimicrobial management to prevent complications and preserve the globe.
Publicações recentes
Rhizopus angle abscess, scleritis and endophthalmitis following Kahook Dual Blade goniotomy and phacoemulsification.
Update on Therapy for Non-Infectious Scleritis.
Is Methotrexate a Superior Alternative to Steroids or Placebo for Scleritis? A Systematic Review and Meta-Analysis on Efficacy and Safety.
Systemic immunosuppressive therapy in idiopathic non-infectious uveitis and scleritis: disease remission, discontinuation, and relapse patterns.
Long-Term Outcomes of 4-Point Expanded Polytetrafluoroethylene and 2-Point Polypropylene Fixation of Scleral-Sutured Intraocular Lenses.
📚 EuropePMC61 artigos no totalmostrando 89
Systemic immunosuppressive therapy in idiopathic non-infectious uveitis and scleritis: disease remission, discontinuation, and relapse patterns.
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle OphthalmologieLong-Term Outcomes of 4-Point Expanded Polytetrafluoroethylene and 2-Point Polypropylene Fixation of Scleral-Sutured Intraocular Lenses.
Journal of vitreoretinal diseasesScleritis Secondary to Eosinophilic Granulomatosis With Polyangiitis.
Journal of vitreoretinal diseasesA Rare Case of Pseudomonas aeruginosa Keratoscleritis: Highlighting Early Diagnosis and Aggressive Treatment.
CureusChronic necrotizing sclerouveitis caused by Alternaria doliconidium.
European journal of ophthalmologyInfectious scleritis: a comprehensive narrative review of epidemiology, clinical characteristics, and management strategies.
Therapeutic advances in ophthalmologyInfectious Scleritis Masquerading as Isolated Orbital Cellulitis: A Case Report.
CureusThe sequential therapy for non-infectious scleritis: A case report.
SAGE open medical case reportsBacterial Infectious Scleritis: A Case Report.
Infection and drug resistanceInfectious scleritis: a review of etiologies, clinical features, and management strategies.
Frontiers in ophthalmologyIncidence and Outcome of Cataract in Eyes with Scleritis and Episcleritis.
Ocular immunology and inflammationPseudomonas-induced scleritis mimicking autoimmune necrotizing scleritis. A case report.
Archivos de la Sociedad Espanola de OftalmologiaOcular scedosporiosis: A case series.
American journal of ophthalmology case reportsEfficacy and tolerability of subcutaneous repository corticotropin injection in refractory ocular inflammatory diseases.
Journal of ophthalmic inflammation and infectionLimbal Subconjunctival Abscess: A Rare Complication of Acanthamoeba Keratitis.
CorneaInfectious Scleritis - Clinical Characteristics, Causative Factors, and Treatment Outcomes in an Indian Population.
Ocular immunology and inflammationBacillus coagulans-associated severe necrotizing scleral infection.
American journal of ophthalmology case reportsAspergillus Endophthalmitis Secondary to Infectious Scleritis: Utility of Diagnostic PCR.
Retinal cases & brief reportsA Case of Incidental and Uncomplicated Subretinal Triamcinolone Acetonide.
Case reports in ophthalmologySubconjunctival Dirofilaria masquerading as nodular scleritis.
BMJ case reportsThe enigma of sclera-specific autoimmunity in scleritis.
Journal of autoimmunityBilateral Scleritis with Heterogeneous Etiologies: A Diagnostic Dilemma.
Ocular immunology and inflammationSurgical induced necrotizing scleritis following intraocular lens replacement.
Journal of ophthalmic inflammation and infectionAdalimumab in the treatment of refractory non-infectious scleritis: 6-month outcomes.
Eye (London, England)Fungal panophthalmitis presenting as severe posterior scleritis.
American journal of ophthalmology case reportsDeterminants of Clinical Outcomes After Infectious Scleritis.
CorneaSuccessful Management of Extensively Drug Resistant Pseudomonas aeruginosa-Infectious Scleritis after Pterygium Surgery.
Ocular immunology and inflammationNecrotizing Scleritis: A Review.
Ocular immunology and inflammationMoraxella nonliquefaciens-associated infectious scleritis.
BMJ case reportsTherapeutic Outcomes of Non-Infectious Scleritis Treated with Tumor Necrosis Factor-Alpha Inhibitors.
Ocular immunology and inflammationSurgically induced scleral necrosis associated with concomitant tuberculosis infection: a diagnostic challenge.
GMS ophthalmology casesGlaucoma Surgical Outcomes in Patients with a History of Scleritis.
Ocular immunology and inflammationEtiology, Pathogens, Clinical Features and Treatment of Bacterial Scleritis.
Seminars in ophthalmologySubpalpebral Antibiotic Lavage for the Treatment of Refractory Infectious Scleritis.
Ophthalmic plastic and reconstructive surgeryNocardia arthritidis scleritis: A case report.
American journal of ophthalmology case reportsClinical features and long-term treatment outcome of posterior scleritis.
Annals of translational medicineAdalimumab plus Conventional Therapy versus Conventional Therapy in Refractory Non-Infectious Scleritis.
Journal of clinical medicineBaricitinib in severe and refractory peripheral ulcerative keratitis: a case report and literature review.
Therapeutic advances in musculoskeletal diseaseSuccessful control of scleritis caused by Nocardia farcinica: A case report.
MedicineA case of bilateral sclerouveitis with secondary glaucoma right eye.
Medical journal, Armed Forces IndiaRole of anterior segment optical coherence tomography in scleral diseases: A review.
Seminars in ophthalmologyPlasmapheresis as a viable treatment option for scleritis.
American journal of ophthalmology case reportsA case of anterior scleritis in association with posterior scleritis - a diagnostic riddle.
GMS ophthalmology casesPossible Synergistic Role of Cryo-Alcohol Therapy in Infectious Scleritis-Scope and Rationale for Expanding Indications and Review of the Literature.
CorneaSubconjunctival Rituximab Administration for the Treatment of Scleritis.
Ocular immunology and inflammationDevelopment and Implementation of the AIDA International Registry for Patients with Non-Infectious Scleritis.
Ophthalmology and therapyThe Association Between Mental Health Disorders and Non-Infectious Scleritis: A Prevalence Study and Review of the Literature.
European journal of ophthalmologyA novel technique of full-thickness scleral debridement in fulminant necrotising infectious scleritis and its outcomes-a consecutive case series.
International ophthalmologyBiologic Therapies and Small Molecules for the Management of Non-Infectious Scleritis: A Narrative Review.
Ophthalmology and therapyClinical Relevance of Autoantibodies and Inflammatory Parameters in Non-infectious Scleritis.
Ocular immunology and inflammationPreserved corneal lamellar transplantation for infectious and noninfectious scleral defects: Three case reports and literature review.
MedicineRituximab for non-infectious Uveitis and Scleritis.
Journal of ophthalmic inflammation and infectionBilateral infectious scleritis from Histoplasma capsulatum in an immunosuppressed uveitis patient.
American journal of ophthalmology case reportsPatterns of Non-Infectious Scleritis across a Tertiary Eye Care Network Using the Indigenously Developed Electronic Medical Record System-eyeSmart.
Ocular immunology and inflammationInfectious Scleritis: Pathophysiology, Diagnosis, and Management.
Eye & contact lensEfficacy and maintenance of rituximab treatment in non-infectious scleritis.
Acta ophthalmologicaSubconjunctival Dirofilariasis Mimicking Infectious Scleritis.
Journal of pediatric ophthalmology and strabismusInfectious Scleritis due to Methicillin-resistant Staphylococcus Aureus after Dengue Viral Fever.
Ocular immunology and inflammationUmbilical amnion and amniotic membrane transplantation for infectious scleritis and scleral melt: A case series.
American journal of ophthalmology case reportsRecalcitrant infective scleritis masquerading an autoimmune necrotising scleritis: a primary presentation of biopsy-proven granulomatosis with polyangiitis.
BMJ case reportsThe clinical and pathogenic spectrum of surgically-induced scleral necrosis: A review.
Survey of ophthalmologyNecrotising fungal scleritis with full-thickness scleral melt and circumferential progression: a novel debridement approach.
BMJ case reportsThe haplotypes of various TNF related genes associated with scleritis in Chinese Han.
Human genomicsThe Existence of Periodontal Disease and Subsequent Ocular Diseases: A Population-Based Cohort Study.
Medicina (Kaunas, Lithuania)Scleritis: Differentiating infectious from non-infectious entities.
Indian journal of ophthalmologyAlternaria chartarum sclerokeratouveitis: A new fungus cause.
Taiwan journal of ophthalmologyEffectiveness of TNF-α blockade in the treatment of refractory non-infectious scleritis: a multicentre study.
Clinical and experimental rheumatologyEffectiveness of pharmacological agents for the treatment of non-infectious scleritis: a systematic review protocol.
Systematic reviewsTuberculous scleritis in a young Asian Indian girl-a case presentation and literature review.
Journal of ophthalmic inflammation and infectionA case report of infectious scleritis with corneal ulcer caused by Scedosporium aurantiacum.
MedicineHistopathological evaluation of scleritis.
Journal of clinical pathologyPattern of Scleritis in an Egyptian Cohort.
Ocular immunology and inflammationOcular Basidiobolomycosis: A Case Report.
Case reports in ophthalmologyInfectious Scleritis: What the ID Clinician Should Know.
Open forum infectious diseasesCombined Tenonplasty and Scleral Graft for Refractory Pseudomonas Scleritis Following Pterygium Removal with Mitomycin C Application.
Journal of ophthalmic & vision researchIontophoretic delivery of dexamethasone phosphate for non-infectious, non-necrotising anterior scleritis, dose-finding clinical trial.
The British journal of ophthalmologyScedosporium apiospermum infectious scleritis following posterior subtenon triamcinolone acetonide injection: a case report and literature review.
BMC ophthalmologyInterventions and Outcomes in Patients with Infectious Pseudomonas scleritis: A 10-Year Perspective.
Ocular immunology and inflammationPseudomonas Scleritis following Pterygium Excision.
Case reports in ophthalmology[Scleritis and episcleritis].
Journal francais d'ophtalmologieInfectious Pseudomonas and Bipolaris scleritis following history of pterygium surgery.
Indian journal of ophthalmologyAnterior infectious necrotizing scleritis secondary to Pseudomonas aeruginosa infection following intravitreal ranibizumab injection.
American journal of ophthalmology case reportsDiagnosis and management of non-infectious immune-mediated scleritis: current status and future prospects.
Expert review of clinical immunologyClinical features and visual outcomes of scleritis patients presented to tertiary care eye centers in Saudi Arabia.
International journal of ophthalmologyConjunctival Sensation in Scleritis.
Ocular immunology and inflammationSuccessful Treatment of Infectious Scleritis by Pseudomonas aeruginosa with Autologous Perichondrium Graft of Conchal Cartilage.
Yonsei medical journalRisk factors and clinical outcomes of bacterial and fungal scleritis at a tertiary eye care hospital.
Middle East African journal of ophthalmologyNodular syphilitic scleritis masquerading as an ocular tumor.
Journal of ophthalmic inflammation and infectionExperience of scleritis and episcleritis at a tertiary center in Southern Taiwan.
Taiwan journal of ophthalmologyAssociações
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Systemic immunosuppressive therapy in idiopathic non-infectious uveitis and scleritis: disease remission, discontinuation, and relapse patterns.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie· 2026· PMID 41498798mais citado
- Chronic necrotizing sclerouveitis caused by Alternaria doliconidium.
- Long-Term Outcomes of 4-Point Expanded Polytetrafluoroethylene and 2-Point Polypropylene Fixation of Scleral-Sutured Intraocular Lenses.
- Scleritis Secondary to Eosinophilic Granulomatosis With Polyangiitis.
- A Rare Case of Pseudomonas aeruginosa Keratoscleritis: Highlighting Early Diagnosis and Aggressive Treatment.
- Rhizopus angle abscess, scleritis and endophthalmitis following Kahook Dual Blade goniotomy and phacoemulsification.
- Update on Therapy for Non-Infectious Scleritis.
- Is Methotrexate a Superior Alternative to Steroids or Placebo for Scleritis? A Systematic Review and Meta-Analysis on Efficacy and Safety.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:648665(Orphanet)
- MONDO:0958264(MONDO)
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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