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[IgG4-related ophthalmic disease: three-case report]
1Department of Ophthalmology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|April 29, 2021
Summary
Immunoglobulin G4-related ophthalmic disease (IgG4-ROD) can cause vision loss and eye swelling. Glucocorticoid treatment improved symptoms, but recurrences were common in these male patients.
Area of Science:
- Ophthalmology
- Rheumatology
- Immunology
Background:
- Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition affecting various organs.
- Ophthalmic manifestations of IgG4-RD, termed IgG4-related ophthalmic diseases (IgG4-ROD), are increasingly recognized.
Observation:
- Three male patients presented with symptoms including unilateral or bilateral vision loss, conjunctival edema, lacrimal gland enlargement, and eyelid swelling.
- All patients exhibited external orbital tissue involvement, consistent with IgG4-ROD.
Findings:
- Diagnosis of IgG4-related ophthalmic diseases was confirmed in all three patients.
- Treatment with glucocorticoids led to initial symptom improvement.
- Long-term follow-up revealed a high recurrence rate, with two patients experiencing one recurrence and one patient experiencing three recurrences.
Implications:
- IgG4-ROD should be considered in the differential diagnosis of orbital inflammatory conditions, especially in male patients with bilateral involvement.
- While glucocorticoids are effective for initial management, the high recurrence rate necessitates long-term monitoring and potentially alternative therapeutic strategies for IgG4-related ophthalmic diseases.
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