IgG4-related ocular adnexal disease mimicking thyroid-associated orbitopathy.
A 72-year-old man presented with bilateral eyelid swelling and redness. An orbital CT scan showed bilateral proptosis, extraocular muscle enlargement and swollen lacrimal glands, mimicking thyroid-associated orbitopathy (TAO) with Hashimoto's thyroiditis (HT). During the patient's clinical course, spontaneous remission of lung consolidation (35 × 26 mm) was seen. A diagnosis of IgG4-related disease (IgG4-RD) was made based on an elevated serum IgG4 level (1,020 mg/dL; normal, 4-108), predominance of IgG4-positive plasma cells (IgG4/IgG: 35/70 in HPF) in the lacrimal glands and typical features of Mikulicz's disease. This report provides a novel description of this unusual disease entity among HT, TAO and IgG4-RD.
The First Department of Medicine, Wakayama Medical University, Japan.
Hidefumi
H
Inaba
Takahiro
T
Hayakawa
Waka
W
Miyamoto
Ken
K
Takeshima
Hiroyuki
H
Yamaoka
Yasushi
Y
Furukawa
Hiromichi
H
Kawashima
Hiroyuki
H
Ariyasu
Hisao
H
Wakasaki
Hiroto
H
Furuta
Masahiro
M
Nishi
Taisei
T
Nakao
Hideyuki
H
Sasaki
Yuka
Y
Okada
Kazuto
K
Matsunaga
Yasushi
Y
Nakamura
Takashi
T
Akamizu
D000291:Adnexal Diseases / Q000175:diagnosis / Q000276:immunology*; D000368:Aged; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000175:diagnosis / Q000276:immunology*; D005260:Female; D049970:Graves Ophthalmopathy / Q000175:diagnosis; D050031:Hashimoto Disease / Q000175:diagnosis; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000378:metabolism; D007765:Lacrimal Apparatus / Q000276:immunology / Q000473:pathology; D008297:Male; D008882:Mikulicz' Disease / Q000175:diagnosis
D007074:Immunoglobulin G