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Steroid induced exophthalmos. A case report.

C J Fan, K L Goh, F Wang

    Australasian Radiology
    |May 1, 1989
    PubMed
    Summary

    A rare case of steroid-induced exophthalmos (bulging eyes) occurred in a patient with systemic lupus erythematosus affecting the kidneys. Computed tomography revealed increased retro-orbital fat as the cause.

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    Area of Science:

    • Ophthalmology
    • Rheumatology
    • Endocrinology

    Background:

    • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
    • Corticosteroid therapy is a cornerstone in managing SLE, but can lead to various side effects.
    • Exophthalmos, or proptosis, is an uncommon but significant ocular complication.

    Observation:

    • A patient with lupus erythematosus and kidney involvement presented with exophthalmos.
    • The patient had a history of prolonged corticosteroid treatment.
    • Ocular examination revealed bilateral proptosis.

    Findings:

    • Computed Tomography (CT) of the orbits demonstrated significant enlargement of the retro-orbital fat.
    • This finding is characteristic of steroid-induced lipodystrophy affecting the orbital tissues.
    • No other orbital abnormalities were identified to explain the proptosis.

    Implications:

    • This case highlights the importance of recognizing steroid-induced exophthalmos in patients with autoimmune diseases on long-term corticosteroid therapy.
    • Ophthalmological and radiological evaluation is crucial for accurate diagnosis.
    • Awareness of this adverse effect can guide management and potentially prevent further ocular complications.

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