Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Suspected idiopathic sclerosing orbital inflammation presenting as immunoglobulin G4-related disease: a case report | Nagai et al. Journal of Medical Case Reports 2011 5 427 http content 5 1 427 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Suspected idiopathic sclerosing orbital inflammation presenting as immunoglobulin G4-related disease a case report Kazuki Nagai1 Kazuo Andoh2 Noriko Nakamura3 and Katsumi Sakata4 Abstract Introduction Idiopathic sclerosing orbital inflammation is a rare and ill-defined heterogeneous entity and a distinct subset of orbital inflammation. Recently attention has been focused on immunoglobulin G4-related disease complicated with fibrotic changes in some other organs with high serum immunoglobulin G4 levels. This report presents a case of suspected idiopathic sclerosing orbital inflammation complicated with high serum immunoglobulin G4 levels. Case presentation An 82-year-old Japanese woman had a 30-year history of chronic thyroiditis. She experienced right ptosis and eyelid swelling. These symptoms gradually developed over five years. The clinical and radiographic findings suggested that our patient had idiopathic sclerosing orbital inflammation. We were unable to obtain our patient s consent to perform a biopsy. While the serum immunoglobulin G level was within the normal limits the serum immunoglobulin G4 level was significantly elevated. The serum immunoglobulin G4 levels decreased after the administration of oral prednisolone at a daily dose of 20 mg. In addition the swelling and ptosis of the right upper eyelid disappeared gradually after four weeks. Our patient was then suspected to have idiopathic sclerosing orbital inflammation complicated with immunoglobulin G4-related disease and chronic thyroiditis. Conclusion An orbital pseudotumor of this type is indicative of idiopathic sclerosing orbital inflammation immunoglobulin G4-related disease. Immunoglobulin G4 may thus be considered a subclass of immunoglobulin G when the serum immunoglobulin G level is within normal limits. Introduction Idiopathic .
