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Orbital angiolymphoid hyperplasia with eosinophilia in a pediatric patient: a case report
, 2, 3, 4, 5
Affiliations- University of Florida College of Medicine, Gainesville, FL, United States
- University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL, United States
- Nemours Children’s Health, Jacksonville, FL, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
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Abstract
A 7-year-old female presented to an outpatient eye clinic with a six-week history of left upper eyelid edema and erythema in the absence of trauma without compromise of visual acuity or extraocular muscle movements and was initially treated as a case of pre-septal cellulitis with antibiotic therapy. Failure of resolution with new onset nasal bleeding after two weeks prompted computed tomography (CT) and magnetic resonance imaging (MRI), showing an orbital mass with radiologic concern for lymphoma or rhabdomyosarcoma. Upon biopsy, the histopathological analysis diagnosed angiolymphoid hyperplasia with eosinophilia (ALHE), a rare condition that infrequently presents with ocular manifestations and more rarely presents in the pediatric population. Most therapeutic management for cutaneous and non-cutaneous ALHE have high rates of recurrence. This case was refractory to oral prednisone treatment but responded to a combination of methotrexate and adalimumab therapy with an 18.5% reduction in volume after three months.
Abstract
A 7-year-old female presented to an outpatient eye clinic with a six-week history of left upper eyelid edema and erythema in the absence of trauma without compromise of visual acuity or extraocular muscle movements and was initially treated as a case of pre-septal cellulitis with antibiotic therapy. Failure of resolution with new onset nasal bleeding after two weeks prompted computed tomography (CT) and magnetic resonance imaging (MRI), showing an orbital mass with radiologic concern for lymphoma or rhabdomyosarcoma. Upon biopsy, the histopathological analysis diagnosed angiolymphoid hyperplasia with eosinophilia (ALHE), a rare condition that infrequently presents with ocular manifestations and more rarely presents in the pediatric population. Most therapeutic management for cutaneous and non-cutaneous ALHE have high rates of recurrence. This case was refractory to oral prednisone treatment but responded to a combination of methotrexate and adalimumab therapy with an 18.5% reduction in volume after three months.
Keywords
ALHE; epithelial hemangioma; images
About this articleTitle
Orbital angiolymphoid hyperplasia with eosinophilia in a pediatric patient: a case report
Journal
Issue
Vol 8 (2023): Continuous Publishing
Article type
Case report
Pages
22-24
Published online
2023-03-31
Page views
2153
Article views/downloads
283
DOI
Bibliographic record
Ophthalmol J 2023;8:22-24.
Keywords
ALHE
epithelial hemangioma
images
Authors
Alex Weaver
Aaron Ross Harris
Nathan Albrecht
Daniel Lattin
Guangiu Luo
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