Biomaterial Database

Tacrolimus ointment 0.03% for treatment of refractory childhood phlyctenular keratoconjunctivitis. 2012

George D Kymionis, and Vardhaman P Kankariya, and Georgios A Kontadakis

Institute of Vision and Optics, University of Crete, Heraklion, Greece. kymionis@med.uoc.gr

OBJECTIVE To report 2 cases of refractory phlyctenular keratoconjunctivitis treated with topical tacrolimus 0.03% ointment (Protopic). METHODS Two white children, aged 5 years and 6 years, respectively, presented with refractory phlyctenular keratoconjunctivitis in 1 eye (left). Both were using corticosteroids and oral erythromycin at presentation with no relief. Examination revealed the presence of catarrhal corneal infiltrates and neovascularization associated with corneal thinning. Topical tacrolimus was added to topical steroids and oral erythromycin twice daily. RESULTS Topical tacrolimus 0.03% ointment was applied into the lower fornix twice a day. In both the patients, improvement in symptoms and signs started within a week of therapy. After 3 weeks of treatment, both patients showed complete resolution of corneal infiltrates and neovascularization. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS Topical tacrolimus 0.03% ointment may be considered in treating severe refractory phlyctenular conjunctivitis.

UI	MeSH Term	Description	Entries
D007166	Immunosuppressive Agents	Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging.	Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D007637	Keratoconjunctivitis	Simultaneous inflammation of the cornea and conjunctiva.	Keratoconjunctivitides
D009824	Ointments	Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons.	Ointment,Paste,Pastes,Salve,Unguent,Salves,Skin Ointment,Unguents,Ointment, Skin
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D003315	Cornea	The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed)	Corneas
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016510	Corneal Neovascularization	New blood vessels originating from the corneal blood vessels and extending from the limbus into the adjacent CORNEAL STROMA. Neovascularization in the superficial and/or deep corneal stroma is a sequel to numerous inflammatory diseases of the ocular anterior segment, such as TRACHOMA, viral interstitial KERATITIS, microbial KERATOCONJUNCTIVITIS, and the immune response elicited by CORNEAL TRANSPLANTATION.	Corneal Angiogenesis,Angiogenesis, Corneal,Corneal Neovascularizations,Neovascularization, Corneal,Neovascularizations, Corneal
D016559	Tacrolimus	A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro.	Anhydrous Tacrolimus,FK-506,FK506,FR-900506,Prograf,Prograft,Tacrolimus Anhydrous,Anhydrous, Tacrolimus,FK 506,FR 900506,FR900506,Tacrolimus, Anhydrous