Heparin in the long-term management of ligneous conjunctivitis: a case report and review of literature.

Mandira Hiremath, James Elder, Fiona Newall, Susan Mitchell, Roxanne Dyas, Paul Monagle

Journal: Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis 2012;22(7):606-9

PMID: 21885957

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Abstract

Ligneous conjunctivitis, secondary to inherited homozygous plasminogen deficiency, is a poorly understood condition that has the potential to hinder normal childhood development if not managed adequately. We report the clinical progression of a child with ligneous conjunctivitis, controlled with daily heparin eye drops, postsurgical excision, for a duration of approximately 5 years at a cost of approximately 30 USD per month. During this time, the patient's progress has been complicated by one occurrence of periorbital cellulitis and also otitis media. The patient has also experienced ocular complications due to the remaining membranous lesion. This case indicates that individual patient factors including plasminogen levels and exposure to triggers of ocular inflammation may influence the clinical progression of ligneous conjunctivitis. Furthermore, this study is one of the first to present over 5-year follow-up of a patient with ligneous conjunctivitis effectively managed with long-term heparin eye drops.

Address: Department of Clinical Haematology, Royal Children's Hospital, Melbourne, Australia.

DOI: 10.1097/MBC.0b013e3283494b52

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MeSH Terms: Adolescent, Adult, Aged, Anti-Inflammatory Agents, Anticoagulants, Child, Child, Preschool, Conjunctiva, Conjunctivitis, Dexamethasone, Female, Follow-Up Studies, Heparin, Humans, Infant, Infant, Newborn, Middle Aged, Ophthalmic Solutions, Orbital Cellulitis, Otitis Media, Pedigree, Plasminogen, Recurrence, Retinoscopy