Silk Road Disease

Mr. Palsamy, 30 years who admitted in a private hospital with facial puffiness, retro orbital pain, presence of cushingoid, seborrhea. He is a known case of epilepsy/hyperlipidemia. On the day of admission, he was hemodynamically stable. Investigations reveals tiny subcortical, flair in bilateral cerebral hemisphere in MRI, signal retro cerebellar cystic lesion in CSF analysis, bulky right lacrimal gland in ophthalmic examination, pan gastritis and esophageal candidiasis in OGD scopy and severe fatty infiltration of liver in USG abdomen. Vitamin-D and Bone density was reduced. He was treated by 2* steroids, anti-inflammatory and laxatives.