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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
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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