title: IgG4 Staining in Thyroid Eye Disease.
abstract: IgG4-related ophthalmic disease is increasingly widely recognized. Moreover, IgG4 staining can occur in other inflammatory diseases. The authors report a case of IgG4 staining of an enlarged, inflamed levator palpebrae superioris in a patient with a past history of thyroid eye disease. A 78-year-old woman with quiescent hyperthyroidism had clinical and radiological evidence of levator palpebrae superioris inflammation without superior rectus involvement. A biopsy was consistent with IgG4-related ophthalmic disease. There was a marked but incomplete response to an orbital injection of triamcinolone. The authors discuss the association between thyroid eye disease and IgG4 staining and the diagnostic issues that arise when IgG4-related ophthalmic disease criteria are fulfilled in patients with other orbital inflammatory conditions.
authors.affiliation: *South Australian Institute of Ophthalmology and Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia; and †Department of Surgical Pathology, SA Pathology, Adelaide, South Australia, Australia.
authors.forename: Irwin
authors.initials: I
authors.lastname: Kashani
authors.forename: Saul N
authors.initials: SN
authors.lastname: Rajak
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kearney
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Andrew
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D000368:Aged; D005260:Female; D049970:Graves Ophthalmopathy / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D009801:Oculomotor Muscles / Q000473:pathology*; D010950:Plasma Cells / Q000473:pathology; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D007074:Immunoglobulin G