両側涙腺腫脹に硬化性胆管炎を合併したIgG4関連疾患の1例

Sclerosing cholangitis and bilateral lacrimal gland swelling in a case of IgG4-related disease

要約　目的：IgG4関連涙腺炎と眼科的に診断され，全身検索で胆管炎が発見された症例の報告。症例：65歳男性が6か月前からの両側の眼瞼腫脹で受診した。眼窩組織の生検で，涙腺にリンパ組織の過形成があり，免疫染色で多数のIgG4陽性細胞があった。血液検査で胆道系酵素が高値であり，腹部CTで硬化性胆管炎が発見された。プレドニゾロン内服で2か月後に眼瞼腫脹が軽快し，胆管炎も寛解した。結論：涙腺腫脹ではIgG4関連涙腺炎であり，全身的に合併症がある可能性がある。

Abstract.　Purpose：To report a case of IgG4-related dacryoadenitis associated with sclerosing cholangitis. Case：A 65-year-old male presented with swelling of bilateral swelling of eyelid since 6 months before. Biopsy of the orbit showed hyperplasia of lymphoid tissue in the lacrimal gland. Immunohistological staining showed numerous cells positive for IgG4. Blood test show elevated value of biliary enzymes. Computed tomography led to the diagnosis of sclerosing cholangitis. Peroral prednisolone was followed by resolution of lid swelling and cholangitis 2 months later. Conclusion：This case illustrates that eyelid swelling may be manifestation of IgG4-related lacrimal adenitis associated with systemic lesion.