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https://hdl.handle.net/2440/90511
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Type: | Journal article |
Title: | An analysis of IgG4-related disease (IgG4-RD) among idiopathic orbital inflammations and benign lymphoid hyperplasias using two consensus-based diagnostic criteria for IgG4-RD |
Author: | Andrew, N. Sladden, N. Kearney, D. Selva, D. |
Citation: | British Journal of Ophthalmology, 2015; 99(3):376-381 |
Publisher: | BMJ Publishing Group |
Issue Date: | 2015 |
ISSN: | 0007-1161 1468-2079 |
Statement of Responsibility: | Nicholas H Andrew, Nicole Sladden, Daniel J Kearney, Dinesh Selva |
Abstract: | AIM: To determine the proportion of idiopathic orbital inflammation (IOI) and orbital benign lymphoid hyperplasia (OBLH) accounted for by immunoglobulin (Ig)G4-related orbital disease (IgG4-ROD) using the comprehensive diagnostic criteria for IgG4-related disease published by Umehara et al and the consensus diagnostic criteria published by Deshpande et al. Secondary aims were to compare the histological and clinical features of IgG4-ROD and non-IgG4-ROD cases, and to compare IgG4-ROD cases diagnosed using the comprehensive diagnostic criteria with those diagnosed using the consensus diagnostic criteria. METHODS: A retrospective histopathological review and clinical case series. 55 cases of biopsy-confirmed non-granulomatous IOI and 10 cases of biopsy-confirmed OBLH were included. The intensity of sclerosis, lymphoplasmacytic infiltration and eosinophilic infiltration was graded from 0 to 3+ using a standardised and validated scoring system. RESULTS: IgG4-ROD accounted for 50% and 40% of cases originally diagnosed as OBLH and 23.6% and 5.4% of cases originally diagnosed as IOI, using the comprehensive diagnostic criteria and the consensus diagnostic criteria, respectively. IgG4-ROD cases had numerous significant histological differences, but relatively few significant clinical differences, from non-IgG4-ROD cases. Compared with the comprehensive diagnostic criteria, the consensus diagnostic criteria identified a group of IgG4-ROD cases with a slightly higher ratio of IgG4+ to IgG+ (p=0.01) and a slightly longer duration of symptoms (p=0.02). CONCLUSIONS: This is the largest review of IgG4 staining among biopsy-confirmed IOI and OBLH. IgG4-ROD accounted for a substantial proportion of OBLH. The prevalence among cases of IOI was considerably reduced when the consensus diagnostic criteria were used in place of the comprehensive diagnostic criteria. |
Keywords: | Inflammation Lacrimal gland Orbit Pathology |
Rights: | © 2015 by the BMJ Publishing Group Ltd. All rights reserved. |
DOI: | 10.1136/bjophthalmol-2014-305545 |
Published version: | http://dx.doi.org/10.1136/bjophthalmol-2014-305545 |
Appears in Collections: | Aurora harvest 2 Medicine publications |
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