Leivo Tiina, Koskenmies Sari, Uusitalo Marita, Tynninen Olli
Helsinki University Eye Hospital, PL 220, 00029 HUS, Helsinki, Finland,
Int Ophthalmol. 2015 Aug;35(4):595-7. doi: 10.1007/s10792-015-0070-x. Epub 2015 Apr 3.
IgG4-related disease is a recently defined inflammatory process characterized by IgG4-bearing plasma cells in the involved tissues. The most common sites of involvement are the pancreas, hepatobiliary tract, salivary glands, lymph nodes, retroperitoneum and orbit, especially the lacrimal glands. Other ocular or ocular adnexal sites are rare. To our knowledge, there is one reported case of a conjunctival involvement. We describe a patient, who had an IgG4-RD mimicking chalazion in the upper eyelid, confined to the tarsus, with multiple skin lesions on the trunk. This is a case report of a 55-year-old female. A 55-year-old female presented with an upper eyelid lesion, which was clinically diagnosed as chalazion and drained three times. Histopathological diagnoses were chalazion and inflammation with mixed cells, respectively. Additionally, the patient had had skin nodules on the trunk for several years. Finally, after a third recurrence, the tarsal eyelid lesion was completely excised. The tarsal pathology specimen showed 85 IgG4 positive plasma cells per HPF and the IgG4/IgG ratio was 0.64, suggesting a probable IgG4-related disease. The re-examined skin lesions resembled histologically the eyelid lesion. It is essential to be aware of IgG4-related disease, including in recurrent chalazia.
IgG4相关性疾病是一种最近定义的炎症过程，其特征是受累组织中存在携带IgG4的浆细胞。最常见的受累部位是胰腺、肝胆管、唾液腺、淋巴结、腹膜后和眼眶，尤其是泪腺。其他眼部或眼附属器部位则较为罕见。据我们所知，有一例结膜受累的报道。我们描述了一名患者，其在上眼睑有一个类似睑板腺囊肿的IgG4相关性疾病，局限于睑板，躯干有多处皮肤病变。这是一名55岁女性的病例报告。一名55岁女性出现上眼睑病变，临床诊断为睑板腺囊肿，并进行了三次引流。组织病理学诊断分别为睑板腺囊肿和混合细胞炎症。此外，该患者躯干出现皮肤结节已有数年。最后，在第三次复发后，完全切除了睑板病变。睑板病理标本显示每高倍视野有85个IgG4阳性浆细胞，IgG4/IgG比值为0.64，提示可能为IgG4相关性疾病。重新检查的皮肤病变在组织学上与眼睑病变相似。认识到IgG4相关性疾病很重要，包括在复发性睑板腺囊肿中。
