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Abstract
Purpose: To describe IgG4-positive sclerosing orbital inflammation with prominent conjunctival and scleral involvement.
Design: Case report.
Methods: Clinical, radiologic, and pathologic correlation.
Results: A 66-year-old man presented with right eye redness and irritation. Examination revealed unilateral scleritis and nongranulomatous anterior uveitis with elevated p-ANCA and CRP. Orbital CT scan showed inferotemporal scleral thickening. Biopsy revealed sclerosis and IgG4-positive plasma cells in the conjunctiva and inferior rectus.
Conclusions: IgG4-mediated sclerosing inflammation is well-recognized in the orbit and adnexa, particularly the lacrimal gland. Scleritis with anterior uveitis should be recognized as a possible presentation for this entity, which has important systemic associations.
ACKNOWLEDGMENT
The authors would like to thank Paul Helgerson, MD, at the Veterans Administration Palo Alto Health Care System Internal Medicine Department for assistance with laboratory workup and patient management. The views expressed in this article are those of the authors and do not necessarily reflect the position or policies of the Department of Veterans Affairs or the United States government.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.