Differential Diagnosis for Nodular Scleritis
- The differential diagnosis for nodular scleritis can be categorized into the following groups:
Single Most Likely Diagnosis
- Inflammatory bowel disease (IBD)-related scleritis: This is the most likely diagnosis due to the strong association between IBD and nodular scleritis. Patients with IBD, such as Crohn's disease or ulcerative colitis, are at increased risk of developing scleritis, including the nodular form.
Other Likely Diagnoses
- Rheumatoid arthritis (RA)-related scleritis: RA is another common systemic disease associated with scleritis, including nodular scleritis. The presence of RA and scleritis can indicate a more severe and chronic disease course.
- Relapsing polychondritis: This rare autoimmune disorder can cause inflammation of the cartilage and other tissues, including the sclera, leading to nodular scleritis.
- Granulomatosis with polyangiitis (GPA): GPA, formerly known as Wegener's granulomatosis, is a vasculitis that can affect various tissues, including the sclera, and cause nodular scleritis.
Do Not Miss Diagnoses
- Sarcoidosis: Although less common, sarcoidosis can cause nodular scleritis and is important to consider due to its potential for systemic involvement and serious complications if left untreated.
- Tuberculosis: Tuberculosis can cause scleritis, including nodular scleritis, and is essential to consider, especially in patients from endemic areas or with a history of tuberculosis exposure.
- Syphilis: Syphilis is another important diagnosis to consider, as it can cause scleritis, including nodular scleritis, and has serious consequences if left untreated.
Rare Diagnoses
- Foreign body-induced scleritis: A retained foreign body, such as a piece of metal or glass, can cause nodular scleritis, although this is a rare occurrence.
- Scleritis associated with other autoimmune disorders: Other autoimmune disorders, such as lupus or ankylosing spondylitis, can rarely cause nodular scleritis.
- Infectious scleritis: Bacterial, fungal, or parasitic infections can cause scleritis, including nodular scleritis, although these are rare and often associated with specific risk factors, such as trauma or immunocompromised states.