Plasminogen Deficiency and Ligneous Conjunctivitis

We present a case of an 18-year-old patient without a family history of ocular disease, born full term without complications, within his first 2 days a mass in the tarsal conjunctiva appeared. Initially he received topical treatment and follow-up by the ophthalmology department with a diagnosis of persistent bilateral conjunctivitis, relapsing tarsal masses and cataracts in both eyes requiring a total of 7 surgical interventions with a poor response. At the age of 6 months he was diagnosed with hydrocephalus and required a ventricular-peritoneal shunt. Given the persistence of the symptoms, further studies were made and a medical board made the diagnosis of ligneous conjunctivitis associated to low levels of plasminogen. The diagnosis was confirmed by decreased levels of plasminogen in serum measured three times with 2 months intervals: 16.9%, 11.1%, 18.6% (reference values 70-150%). Low molecular weight heparin was ordered before surgical procedures, and topical triamcinolone applied according to ocular symptoms.