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Year : 2013  |  Volume : 3  |  Issue : 3  |  Page : 116-119

IgG4-related dacryoadenitis

1 Department of Ophthalmology, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
2 Division of Immunology and Rheumatology, Department of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan

Correspondence Address:
Pei-Yuan Su
Department of Ophthalmology, Far-Eastern Memorial Hospital, 21, Section 2, Nan-Ya South Road, Ban-Chiao District, New Taipei City
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Source of Support: None, Conflict of Interest: None

DOI: 10.1016/j.tjo.2013.05.003

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A 44-year-old female presented with bilateral eyelid swelling and painless, palpable mass over the lacrimal gland area for more than 1 year. A bilateral enlarged lacrimal gland with mild contrast enhancement was noted on computed tomography. Biopsy of the lacrimal gland showed lympho- plasmacytic infiltrate with focal hyaline and sclerotic change, and immunohistochemical staining revealed numerous IgG4-positive plasma cells, which was characteristic of IgG4 dacryoadentitis. Serum IgG and IgG4 levels were within normal range. The patient was treated with surgical excision instead of systemic steroid owing to poor tolerance. No tumor recurrence or systemic involvement was noted during the follow-up period. Our case highlights the importance of IgG4 dacryoadenitis in differentiating bilateral lacrimal gland inflammatory conditions. A normal serum IgG4 level does not rule out the diagnosis and surgical excision may be an alternative for those who are considered ineligible for corti- costeroid treatment.

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