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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-03-2014 | Inflammatory Disorders

Clinical features of IgG4-related dacryoadenitis

Authors: Satomi Koizumi, Terumi Kamisawa, Sawako Kuruma, Taku Tabata, Susumu Iwasaki, Kazuro Chiba, Keigo Setoguchi, Shinichiro Horiguchi, Noriko Ozaki

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2014

Abstract

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 ± 15.1 years) with IgG4-related dacryoadenitis.

Results

In addition to eyelid swelling, other ophthalmologic symptoms were observed in seven patients, including diplopia (n = 4), ptosis (n = 2), visual field disturbance (n = 2), eye pain (n = 2), decrease of visual acuity (n = 2), eye-movement disturbance (n = 1), dry eye (n = 1), corneal ulcer (n = 1), and epiphora (n = 1). Swelling of the lacrimal glands was bilateral in half of the patients. Other IgG4-related diseases were present in nine patients, including sialadenitis (n = 5), autoimmune pancreatitis (n = 4), retroperitoneal fibrosis (n = 2), and lymphadenopathy (n = 8). Serum IgG4 levels were significantly higher in patients with other IgG4-related disease (1070 ± 813 mg/dl) than in those without (197 ± 59 mg/dl, p = 0.017). 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 = 6), inflammation of the optic nerve (n = 2), and retrobulbar inflammation (n = 3). 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.

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Title: Clinical features of IgG4-related dacryoadenitis
Authors: Satomi Koizumi
Terumi Kamisawa
Sawako Kuruma
Taku Tabata
Susumu Iwasaki
Kazuro Chiba
Keigo Setoguchi
Shinichiro Horiguchi
Noriko Ozaki
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2014
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-013-2541-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical features of IgG4-related dacryoadenitis

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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