Location and frequency of lesions in patients with IgG4-related ophthalmic diseases

Sogabe, Yuka; Ohshima, Kohichi; Azumi, Atsushi; Takahira, Masayuki; Kase, Satoru; Tsuji, Hideki; Yoshikawa, Hiroshi; Nakamura, Tetsuya

doi:10.1007/s00417-013-2548-4

Cited by 117 publications

(91 citation statements)

References 30 publications

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“…Similar cases had been reported subsequently by many facilities [4]. It is now known that IgG4-related ophthalmic lesions are not limited to the lacrimal glands but may manifest with various patterns in the orbit and ocular tissues such as extraocular muscles, orbital nerve, and eyelid [6]. …”

Section: Discussionsupporting

confidence: 73%

Immunoglobulin G4-Related Ophthalmic Disease Involving the Sclera Misdiagnosed as Intraocular Tumor: Report of One Case

Gotô

Ueda

2016

Ocul Oncol Pathol

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Aims: Immunoglobulin G4 (IgG4)-related disease is known to have diverse clinical manifestations. We report a case of IgG4-related ophthalmic disease misdiagnosed as intraocular tumor. Methods: Case report. Results: A 41-year-old man was referred to our department with a diagnosis of intraocular tumor, presumably choroidal melanoma. Although MR imaging was compatible with choroidal melanoma, he had been observed periodically without treatment because fundus findings were not typical of melanoma and visual function was preserved. He was again referred to us 15 years later due to increased tumor size and visual field disturbance. Transscleral biopsy of the intraocular tumor was attempted to make a histopathological diagnosis. During the biopsy procedure, thick placoid tissue adhering to the sclera was found at a location consistent with the site of the elevated intraocular lesion. Histopathological examination of this extraocular material revealed proliferation of dense fibrous tissue with follicular proliferation of lymphocytes and plasmacytes. The plasmacytes were diffusely positive for IgG and IgG4. Serum IgG4 level was slightly elevated and no extraocular lesion was detected. Despite administration of systemic corticosteroids after biopsy, the intraocular mass was not reduced. Visual acuity of 20/20 has been maintained as of the last follow-up. Conclusion: IgG4-related disease should be included in the differential diagnosis of intraocular elevated lesion.

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Section: Discussionsupporting

confidence: 73%

Immunoglobulin G4-Related Ophthalmic Disease Involving the Sclera Misdiagnosed as Intraocular Tumor: Report of One Case

Gotô

Ueda

2016

Ocul Oncol Pathol

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“…Earlier reports described IgG4-related disease involving the ocular adnexa as characterized by symmetrical and persistent swelling of the lacrimal and salivary glands as well as prominent infiltration of IgG4-expressing plasmacytes in those glands [5][6][7][8]. However, it is now known that IgG4-related ophthalmic lesions are not limited to the lacrimal glands but may also manifest diffusely in the orbit and in diverse ocular tissues such as the extraocular muscles, orbital nerve (trigeminal nerve branch), and eyelid [13]. In particular, enlargement of the infraorbital or supraorbital nerve, or both, is frequently observed in this disease [13][14][15].…”

Section: History Of Igg4-related Diseasementioning

confidence: 99%

“…However, it is now known that IgG4-related ophthalmic lesions are not limited to the lacrimal glands but may also manifest diffusely in the orbit and in diverse ocular tissues such as the extraocular muscles, orbital nerve (trigeminal nerve branch), and eyelid [13]. In particular, enlargement of the infraorbital or supraorbital nerve, or both, is frequently observed in this disease [13][14][15].…”

Section: History Of Igg4-related Diseasementioning

confidence: 99%

Diagnostic criteria for IgG4-related ophthalmic disease

2014

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Immunoglobulin G4 (IgG4)-related disease is a novel clinical entity characterized by infiltration of IgG4-immunopositive plasmacytes and elevated serum IgG4 concentration accompanied by enlargement of and masses in various organs, including the lacrimal gland, salivary gland, and pancreas. Recent studies have clarified that conditions previously diagnosed as Mikulicz disease as well as various types of lymphoplasmacytic infiltrative disorders of the ocular adnexa are consistent with a diagnosis of IgG4-related disease. Against this background, the diagnostic criteria for IgG4-related ophthalmic disease have recently been established, based on both the clinical and the histopathologic features of the ocular lesions. This article reviews these new criteria with reference to the comprehensive diagnostic criteria for IgG4-related disease for all systemic conditions reported in 2012.

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“…While the lacrimal gland is the most common ophthalmic manifestation in IgG4-related disease, the conjunctiva was initially believed to be spared [4]. Recent case reports have shown conjunctival involvement in IgG4-related disease with adnexal involvement [6,8] or in isolation [7].…”

Section: Discussionmentioning

confidence: 99%

“…The orbital and ocular adnexal manifestations of IgG4-related disease is well documented [2,3,4,5]. The lacrimal gland, orbit, extraocular muscles, trigeminal nerve branch and periorbital fat are commonly involved.…”

Section: Introductionmentioning

confidence: 99%

Isolated Conjunctival Inflammation Suggestive of IgG4-Related Disease

Aziz¹,

Villa‐Forte²,

Plesec

et al. 2015

Ocul Oncol Pathol

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Purpose: In this interventional case report, we present the correlation between an isolated conjunctival inflammatory lesion and IgG4-related disease. Results: A 29-year-old female presented with a solitary conjunctival mass of the right eye. The rest of the ocular examination including orbital assessment was negative. Excisional biopsy was suggestive of IgG4-related disease. The patient was treated with oral steroids and remained disease free at 18 months of follow-up. Conclusions: Isolated conjunctival inflammation without orbital involvement can be considered within the spectrum of IgG4-related disease.

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Location and frequency of lesions in patients with IgG4-related ophthalmic diseases

Abstract: Thirty-four (52.3 %) of the 65 IgG4ROD patients had lesions in areas other than LG. Lesions were found in the trigeminal nerve branch including pterygopalatine fossa, extraocular muscles, orbital fat, eyelid, and nasolacrimal duct.

Cited by 117 publications

References 30 publications

Immunoglobulin G4-Related Ophthalmic Disease Involving the Sclera Misdiagnosed as Intraocular Tumor: Report of One Case

Immunoglobulin G4-Related Ophthalmic Disease Involving the Sclera Misdiagnosed as Intraocular Tumor: Report of One Case

Diagnostic criteria for IgG4-related ophthalmic disease

Isolated Conjunctival Inflammation Suggestive of IgG4-Related Disease

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