Laboratory Investigations for Diagnosis of Autoimmune and Inflammatory Periocular Disease: Part I

Abstract

This review covers important laboratory serological investigations specific to entities routinely encountered by orbitologists. The technique, parameters measured, and clinical importance of each of these laboratory tests are discussed in detail. Due to the extensive nature of the topic, the review has been split into 2 parts. Part I covers thyroid eye disease, IgG4-related disease, and myasthenia gravis. In part II of the review, sarcoidosis, vasculitis, Sjögren syndrome, and giant cell arteritis will be discussed.

CT and MR imaging of orbital inflammation

“…9a, b). Serologic testing includes measuring serum TSH, T3, T4, TSH-r antibody, thyrotropin-binding inhibitory immunoglobulin, and thyroid-stimulating immunoglobulin [32]. Natural history of the disease depicts an active phase followed by an inactive phase.…”

“…Bone remodeling is possible [37]. Increased IgG4 levels in serum will help in making the diagnosis [40], but serum IgG4 can be normal in up to 40% of patients with biopsy-proven disease [32, 38]. The definitive diagnosis is histopathologic typically with abundant IgG4-positive plasma cells and fibrosis [38, 41].…”