Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1995 May;79(5):453–456. doi: 10.1136/bjo.79.5.453

Florid xanthelasmata (yellow lids) in orbital Wegener's granulomatosis.

A B Tullo 1, P Durrington 1, E Graham 1, L P Holt 1, D L Easty 1, R Bonshek 1, J L Noble 1
PMCID: PMC505134  PMID: 7612558

Abstract

AIMS--A new sign of florid xanthelasmata is described in four male patients with orbital manifestations of Wegener's granulomatosis. METHODS--The case notes of four patients with Wegener's granulomatosis, with orbital involvement accompanied by yellow lid lesions, are reviewed. RESULTS--All the patients had active Wegener's granulomatosis at the time the lid lesions were most florid. The lesions gradually resolved as the inflammatory disease was controlled with immunosuppressive agents. The lesions displayed marked asymmetry and predominantly involved the side with the most severe inflammation. Abnormalities of lipid metabolism were not identified and it is believed that the lesions developed in a susceptible anatomical region affected by a vasculitic process. CONCLUSION--A 'yellow lid' associated with orbital inflammation and is a strong pointer to the clinical diagnosis of Wegener's granulomatosis.

Full text

PDF
453

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alper M. G., Zimmerman L. E., Piana F. G. Orbital manifestations of Erdheim-Chester disease. Trans Am Ophthalmol Soc. 1983;81:64–85. [PMC free article] [PubMed] [Google Scholar]
  2. Bullen C. L., Liesegang T. J., McDonald T. J., DeRemee R. A. Ocular complications of Wegener's granulomatosis. Ophthalmology. 1983 Mar;90(3):279–290. doi: 10.1016/s0161-6420(83)34574-7. [DOI] [PubMed] [Google Scholar]
  3. Cornblath W. T., Dotan S. A., Trobe J. D., Headington J. T. Varied clinical spectrum of necrobiotic xanthogranuloma. Ophthalmology. 1992 Jan;99(1):103–107. doi: 10.1016/s0161-6420(92)32031-7. [DOI] [PubMed] [Google Scholar]
  4. Duncker G., Gross W. L., Nölle B., Asmus R., Koltze H., Spielmann R. P., Reinhold-Keller E., Rochels R. Orbitale Beteiligung bei Wegenerscher Granulomatose. Klin Monbl Augenheilkd. 1992 Nov;201(5):309–316. doi: 10.1055/s-2008-1045908. [DOI] [PubMed] [Google Scholar]
  5. Fauci A. S., Haynes B. F., Katz P., Wolff S. M. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med. 1983 Jan;98(1):76–85. doi: 10.7326/0003-4819-98-1-76. [DOI] [PubMed] [Google Scholar]
  6. Jordan D. R., Addison D. J. Wegener's granulomatosis. Eyelid and conjunctival manifestations as the presenting feature in two individuals. Ophthalmology. 1994 Mar;101(3):602–607. doi: 10.1016/s0161-6420(94)31295-4. [DOI] [PubMed] [Google Scholar]
  7. Kalina P. H., Lie J. T., Campbell R. J., Garrity J. A. Diagnostic value and limitations of orbital biopsy in Wegener's granulomatosis. Ophthalmology. 1992 Jan;99(1):120–124. doi: 10.1016/s0161-6420(92)32028-7. [DOI] [PubMed] [Google Scholar]
  8. Leavitt R. Y., Fauci A. S., Bloch D. A., Michel B. A., Hunder G. G., Arend W. P., Calabrese L. H., Fries J. F., Lie J. T., Lightfoot R. W., Jr The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum. 1990 Aug;33(8):1101–1107. doi: 10.1002/art.1780330807. [DOI] [PubMed] [Google Scholar]
  9. Mann J. I., Lewis B., Shepherd J., Winder A. F., Fenster S., Rose L., Morgan B. Blood lipid concentrations and other cardiovascular risk factors: distribution, prevalence, and detection in Britain. Br Med J (Clin Res Ed) 1988 Jun 18;296(6638):1702–1706. doi: 10.1136/bmj.296.6638.1702. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Nölle B., Specks U., Lüdemann J., Rohrbach M. S., DeRemee R. A., Gross W. L. Anticytoplasmic autoantibodies: their immunodiagnostic value in Wegener granulomatosis. Ann Intern Med. 1989 Jul 1;111(1):28–40. doi: 10.7326/0003-4819-111-1-28. [DOI] [PubMed] [Google Scholar]
  11. Robertson D. M., Winkelmann R. K. Ophthalmic features of necrobiotic xanthogranuloma with paraproteinemia. Am J Ophthalmol. 1984 Feb;97(2):173–183. doi: 10.1016/s0002-9394(14)76087-8. [DOI] [PubMed] [Google Scholar]
  12. Robin J. B., Schanzlin D. J., Meisler D. M., deLuise V. P., Clough J. D. Ocular involvement in the respiratory vasculitides. Surv Ophthalmol. 1985 Sep-Oct;30(2):127–140. doi: 10.1016/0039-6257(85)90081-5. [DOI] [PubMed] [Google Scholar]
  13. Rose G. E., Patel B. C., Garner A., Wright J. E. Orbital xanthogranuloma in adults. Br J Ophthalmol. 1991 Nov;75(11):680–684. doi: 10.1136/bjo.75.11.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Smith J. L., Susac J. O. Letter: Unilateral arcus ssenilis: sign of occlusive disease of the carotid artery. JAMA. 1973 Nov 5;226(6):676–676. doi: 10.1001/jama.1973.03230060052030. [DOI] [PubMed] [Google Scholar]
  15. Soukiasian S. H., Foster C. S., Niles J. L., Raizman M. B. Diagnostic value of anti-neutrophil cytoplasmic antibodies in scleritis associated with Wegener's granulomatosis. Ophthalmology. 1992 Jan;99(1):125–132. doi: 10.1016/s0161-6420(92)32027-5. [DOI] [PubMed] [Google Scholar]
  16. Spalton D. J., Graham E. M., Page N. G., Sanders M. D. Ocular changes in limited forms of Wegener's granulomatosis. Br J Ophthalmol. 1981 Aug;65(8):553–563. doi: 10.1136/bjo.65.8.553. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Steinberg D., Parthasarathy S., Carew T. E., Khoo J. C., Witztum J. L. Beyond cholesterol. Modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med. 1989 Apr 6;320(14):915–924. doi: 10.1056/NEJM198904063201407. [DOI] [PubMed] [Google Scholar]
  18. Takahashi K., Naito M. Lipid storage disease: Part I. Ultrastructure of xanthoma cells in various xanthomatous diseases. Acta Pathol Jpn. 1983 Sep;33(5):959–977. doi: 10.1111/j.1440-1827.1983.tb02142.x. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES