title: IgG4-positive sclerosing orbital inflammation involving the conjunctiva: a case report.
abstract: OBJECTIVE
  To describe IgG4-positive sclerosing orbital inflammation with prominent conjunctival and scleral involvement.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Clinical, radiologic, and pathologic correlation.
  
  
  RESULTS
  A 66-year-old man presented with right eye redness and irritation. Examination revealed unilateral scleritis and nongranulomatous anterior uveitis with elevated p-ANCA and CRP. Orbital CT scan showed inferotemporal scleral thickening. Biopsy revealed sclerosis and IgG4-positive plasma cells in the conjunctiva and inferior rectus.
  
  
  CONCLUSIONS
  IgG4-mediated sclerosing inflammation is well-recognized in the orbit and adnexa, particularly the lacrimal gland. Scleritis with anterior uveitis should be recognized as a possible presentation for this entity, which has important systemic associations.
authors.forename: Yannis M
authors.initials: YM
authors.lastname: Paulus
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Cockerham
authors.forename: Glenn C
authors.initials: GC
authors.lastname: Cockerham
authors.forename: Dita
authors.initials: D
authors.lastname: Gratzinger
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001706:Biopsy; D002097:C-Reactive Protein / Q000032:analysis; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D004359:Drug Therapy, Combination; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D010950:Plasma Cells / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D015423:Scleritis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D012598:Sclerosis / Q000175:diagnosis; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D007074:Immunoglobulin G; D014221:Triamcinolone; D002097:C-Reactive Protein; D011241:Prednisone; D008727:Methotrexate