Droopy eyelid due to IgG4-related dacryoadenitis
Droopy eyelid due to IgG4-related dacryoadenitis
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IgG4 相关泪腺炎导致眼睑下垂
DOI：
10.1136/postgradmedj-2020-138416
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发表时间：
2020
影响因子：
5.1
通讯作者：
Otsuka Fumio
中科院分区：
文献类型：
--
作者：
Takase Ryosuke;Hagiya Hideharu;Tokumasu Kazuki;Nishimura Yoshito;Sakurai Atsunobu;Hasegawa Kou;Hanayama Yoshihisa;Otsuka Fumio
一位控制良好的75岁男性2型糖尿病患者因尿路梗阻被转介到我科。他在转诊前1年出现腹膜后纤维化，当时接受了输尿管支架置入。大约在同一时期，右眼同时出现重影和上睑下垂（图1A）。我们对眼眶做了核磁共振；显示双侧泪道肿大，尤其是右侧（图1B， C）。血清IgG4水平升高至3040mg /dL，右侧泪腺镓-67显像显示高摄取。我们对主动脉旁区增厚的腹膜后软组织进行了组织活检，病理分析结果与igg4相关疾病（IgG4-RD）一致。我们以每天0.5 mg/kg的剂量给药强的松龙。复视和眼睑下垂迅速改善（图1D、E、F）。igg4相关性泪腺炎患者可出现多种眼科症状，如复视和上睑下垂。1 .眼上睑下垂的诊断算法建议通过眼眶成像来检测任何潜在的肿块或眼眶周围组织。2特别是igg4相关的眼部病变，其特征是定义明确、低强度
A 75-year-old man with well-controlled type 2 diabetes was referred to our department because of urinary obstruction. He developed retroperitoneal fibrosis 1 year prior to the referral and underwent a ureteral stent insertion at that time. Around the same period, double vision and eyelid ptosis of the right eye coincidentally appeared (figure 1A). We performed MRI of the orbit; it revealed bilateral lacrimal enlargement, especially at the right side (figure 1B, C). The serum IgG4 level elevated to 3040 mg/dL, and gallium-67 scintigraphy showed high uptake at the right lacrimal gland. We performed a tissue biopsy for the thickened retroperitoneal soft tissues in the para-aortic region, and the results of the pathological analysis were consistent with IgG4-related disease (IgG4-RD). We administered prednisolone at a dose of 0.5 mg/kg per day. His diplopia and eyelid ptosis rapidly improved (figure 1D, E, F). Patients with IgG4-related dacryoadenitis present various ophthalmologic symptoms, such as diplopia and ptosis. 1 Diagnostic algorithm for ocular ptosis recommends performing orbital imaging to detect any underlying mass or at the periorbital tissues. 2 In particular, IgG4-related ophthalmic lesions are characterised by well-defined, low-intensity to
DOI：
10.1007/s00417-013-2541-y
发表时间：
2014-03-01
影响因子：
2.7
作者：
Koizumi, Satomi;Kamisawa, Terumi;Ozaki, Noriko
通讯作者：
Ozaki, Noriko