IgG4相关性眼病伴继发性青光眼病例分析

目的 免疫球蛋白G4-相关性疾病(IgG4-RD)是近年来逐渐被认识的一类相对少见的、与淋巴细胞密切相关的系统性疾病,IgG4-RD可累及一个或多个器官,当累及眼部组织时,则称为IgG4相关性眼病(IgG4-ROD)。本文分析IgG4相关性眼病伴继发性青光眼病例,探讨其治疗方法。 方法 分析IgG4相关性眼病伴继发性青光眼患者临床表现,综合组织活检、影像学检查、患者对激素治疗的应答以及长期观察等因素。 结果 血清IgG4水平升高是考虑该病最重要的血清学特征,具有较高的诊断价值,但特异性不高。本病需长期使用糖皮质激素治疗,多数患者对激素治疗应答良好,临床症状和器官功能均可得到改善,IgG4水平也有所降低。 结论 IgG4-ROD导致继发性青光眼是其并发症之一,其手术方式的选择和术后远期效果缺乏临床经验。该病变本身及长期使用激素所引起的眼部并发症值得关注。

Analysis of immunoglobulin G4-related ophthalmic disease associated with secondary glaucoma

Objective Immunoglobulin(Ig)G4-related disease has recently been recognized as a relatively rare systemic lesion with abnormal lymphocytes. IgG4-related disease can involve one or multiple organs, and is called IgG4-related ophthalmic disease(IgG4-ROD)when ocular tissue is involved. To analysis of IgG4-ROD associated with secondary glaucoma and to discuss its treatment method. Methods We analyzed clinical manifestations, biopsy, imaging examinations, the response to hormone therapy, and long-term observation. Results The serum IgG4 level is considered the most important serologic characteristic of the disease and has high diagnostic value but lacks specificity. Most patients respond to long-term glucocorticoid therapy, typically with symptomatic improvement, reductions in the size of masses or organ enlargement, improvement in organ function, and often a decrease in serum IgG4 levels. Conclusion Secondary glaucoma is one of the complications associated with IgG4-ROD, but there is still no consensus regarding the choice of surgical procedure, and the long-term postoperative outcome is unknown. It is important to recognize and address the complications of IgG4-ROD and the side effects associated with use of corticosteroids.