A Case of IgG4-Related Sclerosing Disease Involving the Eyelid in an Idiopathic Sclerosing Myositis Patient.

Yoon, Je Hwan; Jung, Jee Woong; Chi, Mi Jung

doi:2013.54.1.160

J Korean Ophthalmol Soc > Volume 54(1); 2013 > Article

Case Report

Journal of the Korean Ophthalmological Society 2013;54(1):160-164.
DOI: https://doi.org/10.3341/jkos.2013.54.1.160 Published online January 15, 2013.

A Case of IgG4-Related Sclerosing Disease Involving the Eyelid in an Idiopathic Sclerosing Myositis Patient.

Je Hwan Yoon, Jee Woong Jung, Mi Jung Chi

Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea. cmj@gilhospital.com

특발성 경화성외안근염 환자에서 발생한 눈꺼풀의 IgG4 연관경화병증 1예

윤제환⋅정지웅⋅지미정

Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea

Abstract

PURPOSE
To report a case of IgG4-related sclerosing disease involving the eyelid in an idiopathic sclerosing myositis patient. CASE SUMMARY: A 51-year-old woman presented with swelling, redness, and tenderness of the left lower eyelid of 1 month duration had taken an immunosuppressant for idiopathic sclerosing myositis. Eye movements showed limitation all directions but there was no exophthalmos. A palpable mass was noted in the left lower eyelid. The left extraocular muscles were hypertrophied but the lacrimal gland was normal on orbital magnetic resonance imaging. IgG4-related sclerosing disease was confirmed by immunostained biopsy from the left lower eyelid, showing infiltration of IgG4-positive lymphoplasmacytic cells. The patient was given oral steroids and an immunosuppressant and the symptoms did not recur for at least 7 months. CONCLUSIONS: IgG4-related sclerosing disease involving ocular adnexa usually consists of bilateral lacrimal gland involvement. Additionally, the orbital soft tissue involvement without dacryoadenitis is rare. The authors of the present study report a case of IgG4-related sclerosing disease involving the left lower eyelid in an idiopathic sclerosing myositis patient and should be considered in the differential diagnosis of eyelid masses.

Key Words: Eyelid;Idiopathic sclerosing myositis;IgG4-related sclerosing disease;Lacrimal gland