Balakrishnan Poojitha, Vicinanzo Matthew G, Luckett John P, Winokur Tom, Weldon Ryan S, Read Russell W
Department of Ophthalmology and Visual Sciences, University of Alabama School of Medicine, 1720 University Boulevard, Suite 302, Birmingham, AL, 35233, USA.
Alabama Ophthalmology Associates, Birmingham, AL, USA.
J Ophthalmic Inflamm Infect. 2025 Aug 16;15(1):62. doi: 10.1186/s12348-025-00516-3.
To report a case of chronic unilateral nodular anterior scleritis as a rare, isolated presentation of IgG4-related ophthalmic disease.
A fifty-two-year-old patient was evaluated for painful, nodular scleral injection of the right eye, diagnosed as nodular anterior scleritis. There was only a partial response to topical corticosteroid and systemic immunomodulatory therapy. This, in combination with a sharp delineation between normal and abnormal sclera lead to the decision to perform a diagnostic biopsy of the lesion. Histopathology showed an IgG4 lymphoplasmacytic infiltration of the scleral tissue.
There are few documented reports of scleritis as the presenting manifestation of IgG4-related disease. IgG4-related disease is an increasingly recognized etiology to be considered in evaluating and managing scleritis.
报告一例慢性单侧结节性前巩膜炎，作为IgG4相关眼病的一种罕见的孤立表现。
一名52岁患者因右眼疼痛、结节性巩膜充血接受评估，诊断为结节性前巩膜炎。局部使用皮质类固醇和全身免疫调节治疗仅取得部分疗效。这与正常巩膜和异常巩膜之间的清晰界限相结合，促使决定对病变进行诊断性活检。组织病理学显示巩膜组织有IgG4淋巴细胞浆细胞浸润。
作为IgG4相关疾病的首发表现，巩膜炎的文献报道很少。在评估和管理巩膜炎时，IgG4相关疾病是一种越来越被认可的病因。
