Journal
OCULAR IMMUNOLOGY AND INFLAMMATION
Volume 28, Issue 6, Pages 884-887Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/09273948.2019.1643028
Keywords
Confocal microscopy; cornea; dendritic cell; inflammation; nerve; neuropathy
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We report a case of a 41-year old female with systemic lupus erythematosus and Sjogren's syndrome, who developed symptoms of painful small fiber neuropathy (SFN). Examination using in vivo confocal microscopy (IVCM) revealed dense accumulations of putative dendritic cells in the central cornea that was postulated to represent a peripheral neuro-inflammatory response. Interventions with higher dose prednisolone, and then intravenous immunoglobulin resulted in substantial, progressive improvements in her symptoms, which were paralleled by cumulative reductions in corneal dendritic cell density (DCD). This case identifies corneal DCD as a potential non-invasive marker of symptomatic SFN due to inflammatory causes.
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