Combined medical and surgical approach in the management of ligneous conjunctivitis in a pediatric patient: A case report

Abstract

Introduction

Ligneous conjunctivitis (LC), a rare chronic conjunctivitis linked to plasminogen deficiency, poses challenges in research and management due to its complexity. This case report details the combined medical and surgical approach in managing LC in a 1.5-year-old female with congenital hydrocephalus, plasminogen deficiency, and glaucoma.

Case presentation

The patient's LC required a comprehensive treatment plan involving systemic and topical therapies, surgical intervention, and fresh frozen plasma (FFP) infusions via a central line.

Discussion

Managing LC necessitates a comprehensive, individualized approach due to its rarity and lack of standardized treatments. Various therapies have shown promise, but their availability, cost, and potential side effects vary. FFP infusions played a crucial role in managing plasminogen deficiency, but the potential complications associated with central lines must be considered. Ongoing clinical trials aim to improve LC treatment, but until results are available, clinicians must rely on existing evidence and clinical judgment.

Conclusion

This case underscores the complexity of managing LC and the significance of adopting an individualized treatment strategy. Regular follow-ups are crucial for flexibility and adaptability in treatment plans to address potential recurrences. Further research is necessary to validate these findings and assess the long-term effectiveness of the combined approach.

Highlights

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  Rare pediatric case of ligneous conjunctivitis managed with a combination of medical and surgical interventions.

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  Amniotic membrane transplantation (AMT) and topical immunosuppressants show promising results in long-term management.

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  Successful treatment led to the complete resolution of pseudomembranes and improved the patient's quality of life.

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  A multidisciplinary approach and early diagnosis are crucial for effectively managing this rare condition.