title: [Immunoglobulin-G4-related disease: a challenging diagnosis].
abstract: BACKGROUND
  Immunglobulin G4 (IgG4)-related disease was recently described and represents a systemic lymphoproliferative disorder. The orbital form of the disease manifests as chronic lid swelling and proptosis. Visual disturbances may occur due to apical orbital lesions.
  
  
  METHODS
  A 65-year old pacient presents with the impossibility of maintaining his right eye open due to a progressive swelling of the upper lid. The general clinical examination shows adenopathy at 3 lymph node stations of the head. On ophthalmologic examination, a large tumor of the upper lid is observed in the right eye and proptosis and central retinal vein occlusion are noted in the left eye. The serum levels of the IgG are very high. A lymph node biopsy was performed.
  
  
  CONCLUSIONS
  The differential diagnosis between the IgG4-related orbital disease and non-Hodgkin lymphoma is discussed. CONCLUSION The diagnosis criteria for IgG4-related disease are both the high serum levels of IgG4 and the specific immunohistochemistry stains.
authors.forename: Ana
authors.initials: A
authors.lastname: Banc
authors.forename: Cristina
authors.initials: C
authors.lastname: Stan
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005094:Exophthalmos / Q000175:diagnosis; D005142:Eyelid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood*; D007155:Immunologic Factors / Q000097:blood*; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D009918:Orbital Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D012170:Retinal Vein Occlusion / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D007074:Immunoglobulin G; D007155:Immunologic Factors