孤立性结膜炎症作为IgG4相关疾病的一种表现

Isolated Conjunctival Inflammation as a Manifestation of IgG4-Related Disease.

作者信息

Li Ang, Plesec Thomas P, Mileti Linda, Singh Arun D

机构信息

Department of Ophthalmology, Cole Eye Institute, Cleveland Clinic, Cleveland, OH.

Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH.

出版信息

Cornea. 2018 Sep;37(9):1182-1184. doi: 10.1097/ICO.0000000000001638.

DOI:10.1097/ICO.0000000000001638

PMID:29794825

Abstract

PURPOSE

To report a unique case of isolated conjunctival inflammation from IgG4-related disease (IgG4-RD) confirmed by pathology.

METHODS

A single interventional case of conjunctival IgG4-RD.

RESULTS

A 63-year-old woman presented with a chronic, solitary, vascularized, tan-colored, and raised conjunctival lesion measuring 7.5 × 8.0 × 1.2 mm located at the temporal bulbar conjunctiva. An excisional biopsy was diagnostic of IgG4-RD based on the classic fibrosis pattern, 120 IgG4-positive plasma cells per high-power field, and an overwhelming majority of IgG4-positive cells among IgG plasma cells. No orbital or systemic involvement was found on clinical examination, imaging, and laboratory workup. The serum IgG4 level was normal (87.1 mg/dL). The patient was free of recurrence at 6-month follow-up.

CONCLUSIONS

Isolated conjunctival inflammation without orbital involvement can be a presentation of IgG4-RD.

摘要

目的

报告一例经病理证实的IgG4相关疾病（IgG4-RD）导致的孤立性结膜炎症的独特病例。

方法

一例结膜IgG4-RD的介入性病例。

结果

一名63岁女性患者，颞侧球结膜出现一个慢性、孤立、血管化、棕褐色且隆起的结膜病变，大小为7.5×8.0×1.2毫米。切除活检根据典型的纤维化模式、每高倍视野120个IgG4阳性浆细胞以及IgG浆细胞中绝大多数为IgG4阳性细胞，诊断为IgG4-RD。临床检查、影像学检查和实验室检查均未发现眼眶或全身受累。血清IgG4水平正常（87.1毫克/分升）。患者在6个月随访时无复发。