Andron Aleza, Hostovsky Avner, Nair Akshay Gopinathan, Sagiv Oded, Schiby Ginette, Simon Guy Ben-
a New York Eye and Ear Infirmary of Mount Sinai , New York , New York , USA.
b Sheba Medical Center , Tel Hashomer , Israel.
Orbit. 2017 Dec;36(6):359-364. doi: 10.1080/01676830.2017.1337192. Epub 2017 Aug 22.
This study was to determine the prevalence of immunoglobulin G4 (IgG4)-related orbital disease (IgG4-ROD) among patients who have previously undergone biopsy and were diagnosed to have idiopathic orbital inflammatory disease (IOID) or orbital lymphoproliferative disease (OLD), namely, lymphoma and benign reactive lymphoid hyperplasia (BRLH). This is a retrospective cross-sectional study. The charts and slides of all patients who underwent biopsies and were histopathologically diagnosed to have either IOID or OLD were reviewed. Demographics, clinical features, initial histopathological diagnoses, treatment received, and final outcome were noted. Using the diagnostic criteria for diagnosis for IgG4 disease, those cases that would classify as "possible IgG4-related disease (IgG4-RD)" were reviewed, reclassified, and reassigned a diagnosis of IgG4-ROD. We reviewed 105 patients' clinical charts. Of these 105 patients, upon reviewing the histopathology, 18 (17.15%) patients were found to fit the diagnostic criteria for possible IgG4-ROD. Of these 18 patients who were now reassigned the diagnosis of IgG4-ROD, the most common previous histopathological diagnosis was found to be IOID, for eight patients (44%), then BRLH, which was noted in five patients (27.8%), followed by lymphoma, which was noted in two patients (11.1%). Previously diagnosed cases of IOID and OLD were found to fulfill the criteria for IgG4-ROD. Given the advent of recent diagnostic and histopathological techniques, all cases of suspected IOID and OLD should be screened for IgG4-ROD and all previously diagnosed cases must be closely followed up, given the systemic implication of IgG4-RD. Histopathological reassessment of previously diagnosed cases may be considered.
本研究旨在确定既往接受活检并被诊断为特发性眼眶炎性疾病（IOID）或眼眶淋巴增殖性疾病（OLD）（即淋巴瘤和良性反应性淋巴组织增生（BRLH））的患者中免疫球蛋白G4（IgG4）相关眼眶疾病（IgG4-ROD）的患病率。这是一项回顾性横断面研究。对所有接受活检且组织病理学诊断为IOID或OLD的患者的病历和玻片进行了回顾。记录了人口统计学资料、临床特征、初始组织病理学诊断、接受的治疗以及最终结局。使用IgG4疾病的诊断标准，对那些归类为“可能的IgG4相关疾病（IgG4-RD）”的病例进行回顾、重新分类，并重新诊断为IgG4-ROD。我们回顾了105例患者的临床病历。在这105例患者中，经组织病理学检查，发现18例（17.15%）患者符合可能的IgG4-ROD诊断标准。在这18例现重新诊断为IgG4-ROD的患者中，之前最常见的组织病理学诊断是IOID，有8例（44%），其次是BRLH，有5例（27.8%），然后是淋巴瘤，有2例（11.1%）。之前诊断的IOID和OLD病例被发现符合IgG4-ROD标准。鉴于近期诊断和组织病理学技术的出现，所有疑似IOID和OLD的病例均应筛查IgG4-ROD，并且鉴于IgG4-RD的全身影响，所有之前诊断的病例都必须密切随访。可考虑对之前诊断的病例进行组织病理学重新评估。
