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Systemic eosinophilic disease presenting as dacryoadenitis.

Kayla Danesh1, Liza M Cohen2, Yan Liu3

  • 1University of California Los Angeles, Los Angeles, California, USA.

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|September 13, 2021
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Summary
This summary is machine-generated.

Orbital inflammation, specifically dacryoadenitis, can be linked to systemic eosinophilia. Two cases highlight this rare condition, showing improvement with corticosteroids and targeted therapies for eosinophilic diseases.

Keywords:
Dacryoadenitiseosinophiliaeosinophilic asthmaeosinophilic granulomatosis with polyangiitisorbit

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Area of Science:

  • Ophthalmology
  • Pulmonology
  • Rheumatology

Background:

  • Eosinophilic diseases are uncommon, and orbital involvement, such as dacryoadenitis (inflammation of the lacrimal gland), is particularly rare.
  • This study investigates two cases of dacryoadenitis associated with both local and systemic eosinophilia.

Observation:

  • Two male patients, aged 32 and 33, presented with recurrent dacryoadenitis.
  • Both experienced concurrent lower respiratory tract inflammation, and one also reported hand and foot swelling.
  • Peripheral blood eosinophilia was noted in both individuals.

Findings:

  • Biopsies of lacrimal glands and lungs revealed significant eosinophilic infiltration, notably without granuloma, necrosis, or vasculitis.
  • One patient responded well to oral corticosteroids and Mepolizumab (an IL-5 inhibitor).
  • The second patient showed symptom improvement with oral corticosteroids alone.

Implications:

  • These cases suggest a potential link between dacryoadenitis and systemic eosinophilic conditions, possibly on the spectrum of eosinophilic asthma or eosinophilic granulomatosis with polyangiitis.
  • Early recognition and appropriate management, including targeted therapies for eosinophilic disorders, are crucial for patients presenting with these symptoms.
  • Further research is warranted to fully elucidate the relationship between orbital inflammation and eosinophilic diseases.