Scleritis and episcleritis in IgA nephropathy - Case series

IgA nephropathy (IgAN) is primarily a chronic glomerular disease and a common cause of end-stage kidney disease. Ocular involvement is rare, and commonly reported associations include episcleritis, scleritis, and hypertensive retinopathy. We report four cases of scleritis and episcleritis in IgAN from India. We retrospectively reviewed the electronic medical records from January 2004 to January 2024 of all patients with IgAN seen at our institute and analyzed the records of patients with scleritis or episcleritis among them. A total of 94 patients were diagnosed with IgAN and ocular complaints during the study period. Of these, six had scleritis or episcleritis, and four of these, who completed 6 months of follow up, were included in the study. Three of these patients had diffuse non-necrotizing scleritis, and one had only episcleritis. Two of these patients needed immunosuppressive treatment along with oral steroids. Three of them did not have recurrence of scleritis while in our care. One patient had multi-system involvement and also had multiple recurrences before going into remission. IgAN is a rare cause of scleritis and episcleritis. However, diagnosis of the association of these two diseases is vital in using a multidisciplinary management by ophthalmologist and nephrologist. Systemic corticosteroids or immunosuppressants remain the mainstay of treatment with good outcomes.