Clinical features of IgG4-related dacryoadenitis

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• 作者：Satomi Koizumi (1)
  Terumi Kamisawa (1)
  Sawako Kuruma (1)
  Taku Tabata (2)
  Susumu Iwasaki (1)
  Kazuro Chiba (1)
  Keigo Setoguchi (1)
  Shinichiro Horiguchi (3)
  Noriko Ozaki (4)
  
• 关键词：IgG4 ; IgG4 ; related dacryoadenitis ; Lacrimal gland ; Mikulicz’s disease ; Autoimmune pancreatitis
• 刊名：Graefe's Archive for Clinical and Experimental Ophthalmology
• 出版年：2014
• 出版时间：March 2014
• 年：2014
• 卷：252
• 期：3
• 页码：491-497
• 全文大小：371 KB
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• 作者单位：Satomi Koizumi (1)
  Terumi Kamisawa (1)
  Sawako Kuruma (1)
  Taku Tabata (2)
  Susumu Iwasaki (1)
  Kazuro Chiba (1)
  Keigo Setoguchi (1)
  Shinichiro Horiguchi (3)
  Noriko Ozaki (4)
  
  1. Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
  2. Department of Endoscopy, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo, Japan
  3. Department of Pathology, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo, Japan
  4. Department of Ophthalmology, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo, Japan
  
• ISSN：1435-702X

文摘

Background To elucidate the clinical characteristics of IgG4-related dacryoadenitis. Methods Clinical features, laboratory findings, radiological findings, associated diseases, treatment, and prognosis were prospectively examined in 12 patients (seven men, five women; mean age, 60.9?±-5.1?years) with IgG4-related dacryoadenitis. Results In addition to eyelid swelling, other ophthalmologic symptoms were observed in seven patients, including diplopia (n--), ptosis (n--), visual field disturbance (n--), eye pain (n--), decrease of visual acuity (n--), eye-movement disturbance (n--), dry eye (n--), corneal ulcer (n--), and epiphora (n--). Swelling of the lacrimal glands was bilateral in half of the patients. Other IgG4-related diseases were present in nine patients, including sialadenitis (n--), autoimmune pancreatitis (n--), retroperitoneal fibrosis (n--), and lymphadenopathy (n--). Serum IgG4 levels were significantly higher in patients with other IgG4-related disease (1070?±-13?mg/dl) than in those without (197?±-9?mg/dl, p--.017). Allergic histories and elevated serum IgE levels were each detected in six patients. Eight patients showed inflammatory extension beyond the lacrimal gland, such as thickened rectus muscle (n--), inflammation of the optic nerve (n--), and retrobulbar inflammation (n--). Steroid therapy was effective in seven patients, but dacryoadenitis relapsed in two patients with markedly higher serum IgG4 levels and autoimmune pancreatitis. Conclusions IgG4-related dacryoadenitis showed various ophthalmologic symptoms due to extensive inflammation beyond the lacrimal gland, frequent association with other IgG4-related disease or allergic phenomena, and steroid responsiveness.