Early-Onset Pauciarticular Juvenile Rheumatoid Arthritis: A Histopathologic Study

A young girl with early-onset pauciarticular juvenile rheumatoid arthritis suffered from recurrent severe bilateral iridocyclitis. Despite intensive medical therapy, she gradually lost all useful vision and ultimately required bilateral enucleation at the age of 10 years for control of pain and photophobia. Histopathologic study of the eyes revealed in the iris and ciliary body a dense inflammatory infiltrate composed principally of plasma cells, as well as angle closure, a dense cyclitic membrane, retinal detachment, cystoid macula, and optic atrophy. Immunoperoxidase stains showed little immunoglobulin within or around the plasma cells within the ciliary body, although strong reactions for IgG and κ- and λ-light chains were seen in other parts of the eyes.