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IgG4-related disease with cavernous sinus and intra-orbital lesions diagnosed by nasal mucosa biopsy
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- Nakata Ruka
- Department of Clinical Neuroscience and Neurology, Nagasaki University Hospital
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- Yoshimura Shunsuke
- Department of Clinical Neuroscience and Neurology, Nagasaki University Hospital
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- Motomura Masakatsu
- Department of Clinical Neuroscience and Neurology, Nagasaki University Hospital
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- Tsujino Akira
- Department of Clinical Neuroscience and Neurology, Nagasaki University Hospital
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- Hayashi Tomayoshi
- Department of Clinical Pathology, Nagasaki University Hospital
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- Hara Minoru
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Hospital
Bibliographic Information
- Other Title
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- 海綿静脈洞から眼窩内の病変を呈し，鼻粘膜生検が診断に有用であったIgG4関連疾患の1例
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Description
<p>IgG4-related disease is a systemic disease characterized by lesions with IgG4 positive plasma cell infiltration in the involved organs and a raised serum IgG4 level. We report a patient of 70-year-old male presented orbital inflammation of IgG4-related disease. The patient developed right eye pain, double vision, and reduced eye sight. MRI image revealed mild right ocular proptosis and swelling of right carvenous sinus, bilateral intraorbital extraocular muscles and right optic nerve. Right optic nerve showed ring-like enhancement. IgG4-related disease was suspected with increased serum IgG4 level of 355 mg/dl, mediastinal lymphadenopathy and prostate enlargement. Transbronchial lung biopsy and prostate needle biopsy were administered with negative results. The eye related symptoms resolved with time, but serum IgG4 continuously increased. IgG4-related disease was diagnosed by nasal mucosa biopsy, which showed IgG4 positive plasma cells within the inflammatory infiltrate. This report emphasizes the usefulness of nasal mucosa biopsy for the diagnosis of IgG4 related disease with lesions difficult to approach.</p>
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 56 (9), 637-640, 2016
Societas Neurologica Japonica
