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.