title: IgG4 orbital inflammation in a 5-year-old child presenting as an orbital mass.
abstract: IgG4 is a newly known systemic disorder. It can present as orbital inflammation or as an orbital mass. We describe the case of a 5-year-old child with proptosis and globe dystopia who went on to have an orbital biopsy. Initially this was reported to be idiopathic orbital inflammation. After IgG4-RD was considered in the differential, the orbital biopsy was revisited, immunohistochemistry was done and the patient's serum was tested for IgG subclass levels. IgG4-RD was diagnosed and the patient was subsequently treated with prednisone and mycophenolate and made a good recovery. This is the youngest reported case of IgG4-RD in a child.
authors.affiliation: Oculoplastics and Orbital Department, Bristol Eye Hospital, Bristol, United Kingdom. f.kalapesi@unsw.edu.au
authors.forename: Freny Boman
authors.initials: FB
authors.lastname: Kalapesi
authors.forename: Helen Michelle
authors.initials: HM
authors.lastname: Garrott
authors.forename: Corina
authors.initials: C
authors.lastname: Moldovan
authors.forename: Mandy
authors.initials: M
authors.lastname: Williams
authors.forename: Athimalaipet
authors.initials: A
authors.lastname: Ramanan
authors.forename: Helen Mary
authors.initials: HM
authors.lastname: Herbert
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006942:Hypergammaglobulinemia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009918:Orbital Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D016727:Orbital Pseudotumor / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010950:Plasma Cells / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D011241:Prednisone