title: A study of infraorbital nerve swelling associated with immunoglobulin G4 Mikulicz's disease.
abstract: OBJECTIVE
  Recent studies revealed that Mikulicz's disease (MD) should be considered as an immunoglobulin (Ig) G4-related disease with aspects of systemic disorders involving the orbit. This study aimed to analyze the relationship between Immunoglobulin G4 (IgG4)-related MD and infraorbital nerve thickness.
  
  
  METHODS
  We measured infraorbital nerve thickness in 68 patients diagnosed as IgG4-related MD at our hospital and performed computed tomography scans of the head and neck region before treatment and compared these scans with those of the control group.
  
  
  RESULTS
  The mean infraorbital nerve diameter (± standard deviation) was 3.2 ± 1.2 mm in patients with IgG4-related MD, and 2.6 ± 0.3 mm in the control group. Infraorbital nerves were significantly thicker in patients with IgG4-related MD. Nerve swelling was found in 20 of 68 patients (29.4%) with a cutoff value of 3.3 mm because this value was obtained from diameter of nerves in the control group + 2 standard deviation mm. No patients in the control group showed nerve swelling. In addition, we found significant correlations between infraorbital nerve swelling and serum IgG4 levels as well as the existence of multiple organ lesions.
  
  
  CONCLUSIONS
  We found that significant infraorbital nerve swelling occurred in patients with IgG4-related MD and was thought to be a part of IgG4-related disease.
authors.affiliation: Department of Otolaryngology, Sapporo Medical University School of Medicine , Sapporo , Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Takano
authors.forename: Ryoto
authors.initials: R
authors.lastname: Yajima
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Seki
authors.forename: Ayumi
authors.initials: A
authors.lastname: Abe
authors.forename: Motohisa
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Himi
mesh_terms: D000368:Aged; D004487:Edema / Q000276:immunology / Q000473:pathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G; D007765:Lacrimal Apparatus / Q000276:immunology / Q000473:pathology*; D008297:Male; D008442:Maxillary Nerve / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D008882:Mikulicz' Disease / Q000276:immunology / Q000473:pathology*
chemical_list: D007074:Immunoglobulin G
keywords: IgG4; Infraorbital nerve; Mikulicz's disease