Orbital Inflammatory Disease: Unusual Presentation of Enthesitis in an HLA-B27 Spondyloarthropathy

Abstract

Background: Orbital inflammatory disease can complicate many systemic inflammatory disorders, including sarcoidosis, vasculitis, Crohn’s disease, systemic lupus erythematosus, rheumatoid arthritis, myasthenia gravis and scleroderma, but has not been reported with spondyloarthropathies.

Observations: The authors describe a 29-year-old woman who developed orbital myositis, in addition to anterior uveitis, sacroiliitis and peripheral arthritis, as a complication of an underlying HLA-B27 related spondyloarthropathy, which responded temporarily to corticosteroid therapy and more completely to adalimumab.

Conclusions: The patient reported herein presents with orbital inflammation as an extra-articular manifestation of HLA-B27 associated undifferentiated spondyloarthropathy. We propose that enthesitis is the likely mechanism of orbital inflammation in this patient.

KEYWORDS::

• Orbital inflammatory disease
• Orbital myositis
• Spondyloarthropathy
• Enthesitis
• HLA-B27
• Adalimumab

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.