Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease

Coloma-González, I.; Ceriotto, A.; Flores-Preciado, J.; Corredor-Casas, S.; Salcedo-Casillas, G.

doi:10.1016/j.oftale.2015.10.012

ISSN: 2173-5794
e-ISSN: 1989-7286

Archivos de la Sociedad Española de Oftalmología is the official journal of the Ophthalmology Society of Spain, that has over 4,000 members. It gives priority to the publication of basic, translational and clinic research including reviews, original articles, short communications, editorials, letters to the editor and clinic practice guides related to Ophthalmology and its subspecialties. A small section of the journal is reserved for the most relevant papers presented at the annual Congress of the Society. All manuscripts considered for publication are reviewed by expert examiner peers (double blind). The journal is published monthly and even though its official language is Spanish all articles are translated into English to increase the dissemination of scientific information. At present, Archivos is the only Spanish language Ophthalmology journal indexed in PubMed/MEDLINE in addition to other prestigious international databases such as Scopus.

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Vol. 90. Issue 9.

Pages 407-413 (September 2015)

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Vol. 90. Issue 9.

Pages 407-413 (September 2015)

Original article

DOI: 10.1016/j.oftale.2015.10.012

Comparative study of clinical features between unilateral and bilateral orbital IgG4-related disease

Estudio comparativo de los hallazgos clínicos en la enfermedad orbitaria asociada a IgG4 con afectación unilateral vs. bilateral

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I. Coloma-González

Corresponding author

icg_ct@yahoo.es

Corresponding author.

, A. Ceriotto, J. Flores-Preciado, S. Corredor-Casas, G. Salcedo-Casillas

Servicio de Órbita, Párpados y Vía Lagrimal, Hospital Dr. Luis Sánchez Bulnes, Asociación para Evitar la Ceguera IAP, Mexico City Mexico

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Tables (5)

Table 1. Diagnostic criteria for Mikulicz's disease approved by the Japanese Medical Society for Sjogren's Syndrome, 2008.

Table 2. Larger diagnostic criteria for IgG4-related disease, 2011(5).

Table 3. Socio-demographic and clinical variables of the cases at the moment of admission.

Table 4. Final diagnosis and evolution of the cases.

Table 5. Comparative table of unilateral and bilateral cases.

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Abstract

Objective

Descriptive and comparative study of patients with orbital IgG4-related disease.

Material and methods

A review and analysis of the cases diagnosed with inflammatory orbital lesion related to IgG4 by the Ophthalmic Pathology Service in the Hospital Dr. Luis Sánchez Bulnes.

Results

A total of 9 cases were found, in which 66% were women, and with a mean age of 48 years and time to diagnosis of 2 years. Unilateral involvement was observed in 56% of cases. All the females experienced pain, and there was an optimal response to corticosteroid treatment in 100% of patients who required medical treatment (one case showed spontaneous resolution). In bilateral cases (44%), only 25% were female, and none had pain as a presenting symptom. Furthermore, 25% of these patients required a combination with immunosuppressants to control inflammation.

Conclusions

Clinical presentation of patients with unilateral orbital IgG4-related disease differs from those with bilateral involvement.

Keywords:

Orbital tumour

Dacryoadenitis

IgG4-related disease

Inflammatory orbital disease

Mikulicz's disease

Resumen

Objetivo

Análisis descriptivo y comparativo de los pacientes diagnosticados de enfermedad orbitaria asociada a IgG4.

Material y métodos

Se revisaron y analizaron todos los casos diagnosticados de inflamación orbitaria asociada a IgG4 por el servicio de Patología del Hospital Dr. Luis Sánchez Bulnes.

Resultados

Encontramos un total de 9 casos. El 66% fueron mujeres, con una edad media de 48 años y tiempo medio de evolución al diagnóstico de 2 años. El 56% de los casos presentaron afectación unilateral: el 100% eran mujeres con clínica de dolor al ingreso y una respuesta óptima al tratamiento corticoideo en el 100% de los casos que precisaron tratamiento médico (un caso mostró resolución espontánea). En los casos bilaterales (44%) solo el 25% fueron mujeres y ninguno refirió dolor como síntoma de presentación. Además, el 25% de estos pacientes precisó de la combinación con inmunosupresores para conseguir el control del cuadro.

Conclusiones

La presentación clínica de los pacientes con inflamación orbitaria asociada a IgG4 difiere según sea una afectación uni- o bilateral.

Palabras clave:

Tumor orbitario

Dacrioadenitis

Enfermedad asociada a IgG4

Enfermedad inflamatoria de la órbita

Enfermedad de Mikulicz

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