Treatment of Ligneous Conjunctivitis Using Topical Plasminogen Therapy in an 8-Week-Old Female Infant

Area of Science:

• Ophthalmology
• Pediatrics
• Hematology

Background:

• Ligneous conjunctivitis is a rare, chronic inflammatory condition characterized by the formation of thick, woody-like membranes on the conjunctiva.
• It is often associated with a deficiency in plasminogen, a key protein in the fibrinolytic system.
• This case highlights the challenges in managing recurrent and severe forms of the disease in infants.

Observation:

• An 8-week-old female infant presented with bilateral eyelid swelling and conjunctival membranes.
• Initial treatment involved surgical excision of membranes, but recurrence was rapid and persistent.
• Standard therapies including topical cyclosporine, heparin, and fresh frozen plasma (FFP) transfusions proved ineffective.

Findings:

• Topical plasminogen administration successfully prevented the recurrence of conjunctival membranes.
• Intravenous plasminogen therapy was effective in treating the systemic manifestations of ligneous conjunctivitis.
• This demonstrates the critical role of plasminogen in managing both ocular and systemic aspects of the disease.

Implications:

• Plasminogen replacement therapy represents a promising therapeutic strategy for ligneous conjunctivitis, particularly in cases refractory to conventional treatments.
• Early diagnosis and targeted plasminogen therapy can potentially prevent severe complications and improve outcomes for affected infants.
• Further research into the underlying mechanisms and optimal dosing of plasminogen therapy is warranted for this rare pediatric condition.