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WED 242 A challenging case of periorbital swelling

Journal of neurology, neurosurgery and psychiatry, 2018-10, Vol.89 (10), p.A35-A35 [Peer Reviewed Journal]

2018, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;2018 2018, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;ISSN: 0022-3050 ;EISSN: 1468-330X ;DOI: 10.1136/jnnp-2018-ABN.122

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  • Title:
    WED 242 A challenging case of periorbital swelling
  • Author: Aginor, Spanoulis ; Papastergiou, Yalatia ; Mitropoulou, Panagiota ; Burke, Georgina
  • Subjects: Edema
  • Is Part Of: Journal of neurology, neurosurgery and psychiatry, 2018-10, Vol.89 (10), p.A35-A35
  • Description: A 54 year old lady was referred with a eighteen month history of slowly progressive, asymmetric, periorbital and facial oedema. She was thought to have inflammatory orbital pseudotumour.During this time, she had also developed a dry mouth, joint pains and enlarged salivary glands. A salivary gland ultrasound scan was suggestive of Sjogren’s disease although antinuclear antibody and rheumatoid factor were negative. She had recently been prescribed omeprazole for mild dysphagia and hoarse voice from vocal cord oedema.Past medical history included Hashimoto thyroiditis for which she was taking levothyroxine.Clinical examination revealed peri-orbital and facial oedema causing proptosis of the right globe and complete lid closure. Visual acuity, eye movements and visual fields of the left eye were normal. Her voice was hoarse and she had mouth ulcers. She had a widespread erythematous rash that was thought to be a drug reaction to omeprazole.Apart from mild lymphopenia and mildly deranged liver function, blood tests, including inflammatory markers and thyroid function, were unremarkable.MRI of the brain and orbits revealed diffuse oedema of facial structures, including the orbital muscles. A CT body scan was unremarkable.A temporalis muscle biopsy confirmed a high grade NK/T cell lymphoma.
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0022-3050
    EISSN: 1468-330X
    DOI: 10.1136/jnnp-2018-ABN.122
  • Source: ProQuest One Psychology
    AUTh Library subscriptions: ProQuest Central
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