Successful infliximab treatment of posterior scleritis in a 13-year-old child refractory to other immunosuppressive therapy.

BACKGROUND

Posterior scleritis is a potentially blinding inflammatory disorder rarely seen in children. Standard care consists of systemic administration of steroids and immunosuppressants such as methotrexate or ciclosporin A. We describe the case of a young girl suffering from therapy refractory posterior scleritis successfully treated with the tumor necrosis factor (TNF) inhibitor infliximab.

METHODS

This study was an interventional case report. The medical chart of a 13-year-old child treated with infliximab (5 mg/kg, 10 applications at a 4-8 week interval) was reviewed for changes of visual acuity, fundoscopy, optic choherence tomography, ultrasound imaging, and adverse events.

RESULTS

Infliximab therapy (5 mg/kg, 10 applications at a 4-8 week interval) led to a long-term remission of posterior scleritis after unsuccessful therapy with high dose prednisolone, methotrexate, and ciclosporin A. To date no side effects have been reported.

CONCLUSIONS

Administration of infliximab may be considered under appropriate circumstances to treat children with posterior scleritis.