Serologic factors in early relapse of IgG4-related orbital inflammation after steroid treatment

Am J Ophthalmol. 2013 Feb;155(2):373-379.e1. doi: 10.1016/j.ajo.2012.07.024. Epub 2012 Oct 27.

Abstract

Purpose: To determine whether serologic factors correlate with early relapse in cases of IgG4-related orbital inflammation, a lymphoproliferative disorder.

Design: Retrospective cohort study.

Methods: We examined the orbital images and serum data of 30 patients with (n=24) or without (n=6) corticosteroid treatment before and after corticosteroid treatment and 6 months after discontinuation of corticosteroid treatment.

Results: Seven patients (23%) (all with corticosteroid treatment) had elevated serum levels of rheumatoid factor. Of the 24 patients with corticosteroid treatment, 24 (100%) showed regression of the lesion, but 8 of the 24 (33%) showed relapse. The serum IgG4 levels before and after corticosteroid treatment were not significantly different between the relapsed and nonrelapsed groups (P=.5 and P=.2, respectively). However, the incidence of patients who were rheumatoid factor-positive was significantly higher in the relapsed group (P=.02). The 6 patients without corticosteroid treatment showed minor proliferation or regression of the lesion at the 6-month follow-up.

Conclusions: The serum rheumatoid factor level may correlate with proliferative activity in IgG4-related orbital inflammation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Antinuclear / blood
  • Cohort Studies
  • Female
  • Flow Cytometry
  • Fluorodeoxyglucose F18
  • Gallium Radioisotopes
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged
  • Orbital Pseudotumor / blood*
  • Orbital Pseudotumor / diagnostic imaging
  • Orbital Pseudotumor / drug therapy*
  • Positron-Emission Tomography
  • Receptors, Interleukin-2 / blood
  • Recurrence
  • Retrospective Studies
  • Rheumatoid Factor / blood*
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Antinuclear
  • Gallium Radioisotopes
  • Glucocorticoids
  • Immunoglobulin G
  • Receptors, Interleukin-2
  • SS-A antibodies
  • Fluorodeoxyglucose F18
  • Rheumatoid Factor