复发性IgG4相关性眼病完全切除术后的糖皮质激素撤减
Corticosteroid Withdrawal after Complete Resection of Recurrent IgG4-Related Ophthalmic Disease.
作者信息
Hamano Yuki, Kitaguchi Yoshiyuki, Nishida Kohji
机构信息
Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, Suita, Osaka, Japan.
出版信息
Neuroophthalmology. 2020 Mar 18;45(3):184-188. doi: 10.1080/01658107.2020.1729817.
Corticosteroids are the first-line treatment for immunoglobulin G4-related ophthalmic disease (IgG4-ROD). However, the therapeutic effect of corticosteroids is unpredictable, and recurrences occur frequently. We present a case of a 60-year-old woman with IgG4-ROD of the lacrimal fossa. She was first treated with oral prednisolone, which was tapered within three months. However, proptosis recurred two months after prednisolone withdrawal. En bloc excision of the lesion was performed via the eyelid crease approach. The patient is lesion-free without corticosteroids at 18 months after surgery. Complete resection can be a powerful strategy for IgG4-ROD if a well-defined lesion is located in accessible areas.
糖皮质激素是免疫球蛋白G4相关性眼病（IgG4-ROD）的一线治疗药物。然而，糖皮质激素的治疗效果不可预测，且复发频繁。我们报告一例60岁女性泪腺窝IgG4-ROD患者。她最初接受口服泼尼松龙治疗，在三个月内逐渐减量。然而，泼尼松龙停药两个月后眼球突出复发。通过睑皱襞入路对病变进行整块切除。术后18个月，患者在未使用糖皮质激素的情况下无病变。如果明确界定的病变位于可及区域，完整切除可能是IgG4-ROD的有效治疗策略。
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