Supplementary Table 1.
Summary of published cases of orbital myositis in patients with systemic lupus erythematosus or discoid lupus erythematosus.
| Author | Age (years)/sex | Involved muscles | SLE/DLE diagnosis (duration) | Therapy at time of presentation | Systemic symptoms | Labs | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|
| Case in presentation | 45/F | Right lateral rectus | SLE (4 years) | Azathioprine 200 mg daily, Prednisone 5 mg daily | No | CRP 4 mg/L CK 27 U/L Anti-dsDNA 2.6 IU/mL C3 0.92 g/L C4 0.1 g/L |
Methylprednisolone 1 g IV Methylprednisolone daily × 3 days, prednisone 60 mg (1 mg/kg) daily with slow taper Switch from azathioprine to Cellcept | Symptoms resolved |
| SLE | ||||||||
| Rico et al. (7) | 49/F | Right superior rectus and superior oblique | SLE (10 years) | Azathioprine 50 mg three times a day Prednisone 5 mg daily Belimumab 640 mg IV every 4 weeks | No | Anti-dsDNA 167 IU/mL C3 0.76 g/L C4 0.07 g/L |
Methylprednisolone 1 g by mouth daily × 5 days, then prednisone with slow taper and rituximab | Symptoms resolved |
| Santosa et al. (9) | 38/F | Left lateral rectus | SLE | Methotrexate Prednisolone | No | ESR 102 mm/h CK normal | High-dose IV steroids | Symptoms resolved |
| Stavrou et al. (8) | 73/F | Non-specified | SLE (3 weeks) | Prednisolone 0.8 mg/kg/d | No | Not reported | Topical dexamethasone 0.1% and carteolol 1% Acetazolamide 500 mg by mouth daily Cyclophosphamide 10 mg/kg IV IVIG 0.5 g/kg/d × 3 days | Proptosis and edema resolved but had permanent visual deficit* |
| Serop et al. (2) | 41/F | Right lateral and inferior rectus Left medial rectus | No diagnosis | None | Yes | ESR 27 mm/h Aldolase normal Anti-dsDNA positive |
Prednisolone 64 mg/d Azathioprine 150 mg/d |
Symptoms resolved, with no recurrence within a year |
| Grimson et al. (11) | 39/M | Left lateral and medial rectus Right lateral rectus | SLE (7 years) | Hydroxychloroquine 200 mg daily Quinacrine hydrochloride 50 mg four times a day | Yes | CK 5236 U/L Aldolase high C3 22 g/L C4 3 g/L |
Methylprednisolone 60 mg IV daily, then 40 mg IV twice a day when symptoms persisted, then prednisone 100 mg by mouth daily with slow taper over 3 months | Symptoms resolved |
| Weinstein et al. (12) | 32/F | L superior rectus, left lateral rectus, R medial rectus | SLE | Hydroxychloroquine 250 mg daily Prednisone 5 mg daily | No | ESR 29 mm/h CK <8 mg/100 mL C3 mildly decreased C4 mildly decreased |
Prednisone 80 mg daily × 1 week, then taper over 6 months | Symptoms resolved, with one recurrence within 6 months |
| DLE | ||||||||
| Arrico et al. (13) | 37/F | Left medial rectus | DLE (5 years) | Not reported | No | ESR 20 mm/h CK normal C3 normal C4 normal |
Methylprednisolone 1 g IV daily × three days, then prednisone 20 mg by mouth daily with tapering 5 mg per week | Symptoms resolved with one recurrence within 6 months |
| Kono et al. (14) | 42/F | Bilateral medial and lateral rectus | DLE (10 years) | Mizoribine 50 mg daily | No | CK normal Anti-dsDNA negative C3 normal C4 normal |
Methylprednisolone 1 g IV daily × 3 days, then prednisone 20 mg by mouth daily | Symptoms resolved |
*
This patient also had ocular ischemia.
SLE: systemic lupus erythematosus; DLE: discoid lupus erythematosus; CRP: C-reactive protein; CK: creatine kinase; ESR: erythrocyte sedimentation rate; F: female; M: male.