Visual impairment in immunoglobulin G4‑related disease: A case report

Wang, Xue; Sun, Xiaodi; Ao, Ran; Zeng, Zilu; Li, Dan; Li, Yiling

doi:10.3892/etm.2021.9633

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…The ophthalmologic clinical hallmark of IgG4-related ocular disease is bilateral lacrimal gland enlargement with three features: suborbital nerve enlargement [7], exophthalmos, and compressive optic neuropathy [4]. IgG4-related optic neuropathy is commonly caused by compression of the optic nerve by enlargement of the lacrimal glands or other intraorbital tissues [4,[8][9][10][11]. Few studies have reported on optic neuropathy caused by compression of the optic chiasm by an enlarged pituitary gland, as in the present case [5,10,11].…”

Section: Discussionmentioning

confidence: 99%

A Case of Immunoglobulin G4-Related Ophthalmic Disease With Unilateral Visual Field Impairment

Kohno¹,

Tabuchi²,

Fukushima³

2022

Cureus

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A 76-year-old man receiving maintenance therapy with oral steroids for immunoglobulin G4 (IgG4)-related disease presented to our hospital with the chief complaint of visual disturbance. His best corrected visual acuities of the right and left eye were 1.2 and 0.7, respectively. Humphrey visual field test revealed inferior auriculotemporal one-quarter blindness in the left eye. After detailed history-taking for IgG4-related disease, clinical diagnosis based on imaging revealed the marked pituitary/pituitary stalk enlargement with associated optic chiasm compression. Based on the history and initial evaluation findings, a diagnosis of IgG4-related ophthalmic disease was made. Intensified steroid therapy was performed, which led to symptom resolution. IgG4-related diseases are considered in the differential diagnosis when bilateral hemianopsia is observed. When unilateral visual acuity and visual field defects are present, IgG4-related diseases and other organ disorders should be considered.

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Section: Discussionmentioning

confidence: 99%

A Case of Immunoglobulin G4-Related Ophthalmic Disease With Unilateral Visual Field Impairment

Kohno¹,

Tabuchi²,

Fukushima³

2022

Cureus

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“…In addition to contraindications, corticosteroids are recommended as first-line drugs for relief induction in all active or untreated IgG4-RD patients. [7][8][9] Patients with IgG4-RD are prone to disease recurrence and cancer risk during maintenance treatment. The following is a summary of IgG4-RD related treatment options.…”

Section: Treatmentmentioning

confidence: 99%

IgG4-related autoimmune pancreatitis and sclerosing cholangitis: A case report and literature review

Wang,

Zhu,

Xiang

et al. 2024

Medicine

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Rationale: Immunoglobulin G4-related disease (IgG4-RD) can involve various organs throughout the body, primarily manifesting as endocrine dysfunction, visual impairment, jaundice, and limited sexual function. IgG4-related autoimmune pancreatitis is triggered by autoimmune reactions and characterized by structural changes in the pancreas and pancreatic ducts. The disease mainly affects middle-aged and elderly males, typically presenting as progressive painless jaundice and misdiagnosed as cholangiocarcinoma or pancreatic cancer. Patient concerns: This study reports a 54-year-old male who consulted with different institutions multiple times due to diabetes, pancreatitis, elevated liver enzymes, and jaundice. Diagnoses: Magnetic resonance imaging revealed swollen head of the pancreas and atrophic tail. Liver and pancreatic tissue pathology showed IgG4 plasma cell infiltration, while liver biopsy indicated interface hepatitis, liver fibrosis, and pseudolobule formation, with no evidence of bile duct damage. Interventions: Following hormone therapy, the patient’s serum IgG4 levels and liver enzyme levels returned to normal. Outcomes: The disease relapsed 2 years after maintaining hormone therapy, and the patient underwent additional hormone-induced remission therapy combined with azathioprine. Lessons: The purpose of this research report is to enhance the awareness and understanding of IgG4-RD, emphasizing the necessity for personalized treatment strategies that take into account its recurrence, associations, and imaging features. This report provides valuable insights and guidance for clinicians in managing and diagnosing patients with IgG4-RD.

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Visual impairment in immunoglobulin G4‑related disease: A case report

Cited by 2 publications

References 24 publications

A Case of Immunoglobulin G4-Related Ophthalmic Disease With Unilateral Visual Field Impairment

A Case of Immunoglobulin G4-Related Ophthalmic Disease With Unilateral Visual Field Impairment

IgG4-related autoimmune pancreatitis and sclerosing cholangitis: A case report and literature review

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