Clinical Study Of Orbital IgG4-Related Diseases

Objective: To investigate the clinical manifestations and imaging features of orbital Ig G4-related diseases by observing the histopathological changes of Ig G4-related orbital diseases,and to explore the relationship between Ig G4 and non-specific inflammatory orbital disease.Histopathological examination of the early diagnosis of the characteristics of the clinical basis.Methods: From June 2011 to May 2015,23 patients with nonspecific orbital orbital disease were treated with ophthalmology at the First Central Hospital of Tianjin.The histopathological examination was performed on histopathology and immunology.Histochemistry was observed and the pathologic characteristics were summarized.The clinical data of 9 patients with orbital Ig G4-related diseases confirmed by pathology were observed and analyzed.The patients were examined by laboratory,age of onset,sex,ocular manifestation,imaging(CT and MRI),hormone therapy and follow-up The prognosis of patients,analysis of its clinical and imaging features,to find in addition to pathological diagnosis of the early diagnosis of clinical basis,help with other orbital disease differential diagnosis.Results: All the 9 cases of non-specific inflammatory orbital disease were confirmed by pathology.The absolute value of 9 cases of 9 cases of Ig G4 positive plasma cells was more than 50 / HPF,and the ratio of Ig G4 / Ig G positive plasma cells was more than 40%.Compliance with Ig G4-related diagnosis of orbital disease.Orbital Ig G4-related diseases mainly in bilateral lacrimal gland painless swelling as the main eye common symptoms.The lesion is most likely to invade the lacrimal gland tissue,followed by the extraocular muscles.Laboratory examination of blood Ig G4 levels were significantly increased.The disease has a higher prompt meaning,but not a specific sign.Some patients serum eosinophils increased,suggesting that the disease and patients with allergies.Orbital Ig G4-related disease in patients with chronic clinical course: bilateral or unilateral painless eyelid swelling,eyeballs,but also blurred vision,pain around the eyes and other symptoms.Orbital IgG4-related disease imaging often shows that the affected organs appear diffuse or localized swelling,accompanied by infraorbital nerve thickening or extraocular muscle swelling a nd so on.The infancy of the infraorbital nerve is a characteristic imaging change of Ig G4-RD.And Ig G4-ROD optic nerve involvement mainly manifested as oppressive disease characteristics.Orbital Ig G4-related disease is a disease based on pathological diagnosis,mainly in a large number of lymphocytes and plasma cell infiltration as the main feature,involving a variety of orbital tissue structure,but mainly lacrimal gland.Patients with systemic hormone therapy was effective,lacrimal gland swelling subsided,serum Ig G4 decreased,but extensive sclerosis effect is not obvious,early and active biopsy for the diagnosis of lesions is very meaningful,combined with imaging findings and follow-up Help to provide the basis for early diagnosis.Conclusion: The orbital Ig G4-related diseases are mainly composed of bilateral painless orbital swelling as the first symptom.The lesion is mainly composed of a large number of Ig G4-positive plasma cell infiltration.The lesion may involve a variety of orbital structures,and the orbital tissue is diffuse or Localized enlargement,accompanied by infraorbital nerve thickening.The disease of infraorbital nerve thickening may be one of its characteristic imaging features,help to provide in addition to pathological diagnosis of the basis of early diagnosis,help early detection of the disease and active biopsy and serological examination.Early diagnosis for the treatment and prognosis of the disease is very meaningful,fully integrated with its imaging,clinical manifestations,laboratory tests to minimize misdiagnosis and missed diagnosis.