{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:43Z","timestamp":1756339543276,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,20]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Granulomatosis with polyangiitis (GPA) is a rare disorder characterised by inflammation of small-sized and medium-sized blood vessels that result in damage to various organ systems, but it most commonly affects the respiratory tract and kidneys. It is one of the few entities that can present with ocular inflammation as well as renal impairment at the same time. We describe a case of a 38-year-old man with conjunctivitis, episcleritis, anterior uveitis as a first manifestation of GPA. His presentation with red eye and anterior uveitis prompted further workup, which revealed acute renal failure (creatinine 442\u2009mmol\/L), elevated inflammatory markers (erythrocyte sedimentation rate of 85\u2009mmol\/hour and C reactive protein of 72\u2009mg\/L), and a c-antineutrophil cytoplasmic antibody titre &gt;8. An urgent renal biopsy was performed demonstrating necrotising crescentic glomerulonephritis, which led to the final diagnosis of GPA. Treatment induction with intravenous methylprednisolone and plasmapheresis followed by an oral prednisone taper and intravenous rituximab infusions leading to resolution of all symptoms and normalisation of kidney function. This report highlights conditions that can present with both ocular inflammation and renal dysfunction with a focus on GPA and its ocular manifestations.<\/jats:p>","DOI":"10.1136\/bcr-2021-243558","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T13:06:14Z","timestamp":1635339974000},"page":"e243558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Conjunctivitis, episcleritis and anterior uveitis as the first presenting features of granulomatosis with polyangiitis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8519-0995","authenticated-orcid":false,"given":"Lucas Donato","family":"Foster","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Nyugen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Margolin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"2025082709232110000_14.10.e243558.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-98-1-76"},{"key":"2025082709232110000_14.10.e243558.2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s40123-019-0176-8","article-title":"Ocular manifestations of granulomatosis with polyangiitis: a review of the literature","volume":"8","author":"Sfiniadaki","year":"2019","journal-title":"Ophthalmol Ther"},{"key":"2025082709232110000_14.10.e243558.3","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5582\/irdr.2016.01014","article-title":"Granulomatosis with polyangiitis (Wegener's disease): an updated review of ocular disease manifestations","volume":"5","author":"Kubaisi","year":"2016","journal-title":"Intractable Rare Dis Res"},{"key":"2025082709232110000_14.10.e243558.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"2025082709232110000_14.10.e243558.5","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.joco.2017.11.003","article-title":"Conjunctivitis as a manifestation of Wegener's granulomatosis","volume":"30","author":"Nejabat","year":"2018","journal-title":"J Curr Ophthalmol"},{"key":"2025082709232110000_14.10.e243558.6","first-page":"CS135","article-title":"Orbital tumor as an initial manifestation of Wegener's granulomatosis in children: a series of four cases","volume":"15","author":"Chipczy\u0144ska","year":"2009","journal-title":"Med Sci Monit"},{"key":"2025082709232110000_14.10.e243558.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2005.12.003"},{"key":"2025082709232110000_14.10.e243558.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91555-9"},{"key":"2025082709232110000_14.10.e243558.9","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4078\/jrd.2019.26.3.156","article-title":"Classification of antineutrophil cytoplasmic antibody-associated vasculitis","volume":"26","author":"Lee","year":"2019","journal-title":"J Rheum Dis"},{"key":"2025082709232110000_14.10.e243558.10","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1002\/art.40577","article-title":"Epidemiology and outcomes of granulomatosis with polyangiitis in pediatric and working-age adult populations in the United States: analysis of a large national claims database","volume":"70","author":"Panupattanapong","year":"2018","journal-title":"Arthritis Rheumatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:23:31Z","timestamp":1756311811000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,27]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bcr-2021-243558"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243558","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}