IgG4関連疾患の眼病変

IgG4-related ophthalmic disease

眼窩領域にはIgG4関連疾患がしばしば発生する．IgG4関連ミクリッツ病はその典型と考えられているが，実際には片側性や涙腺以外の軟部組織に病巣の広がるケースが両側均等の涙腺腫脹を示す症例よりも多い．時に，涙腺腫脹が全くみられない眼窩軟部組織のIgG4関連病変も存在する．鑑別診断としてはMALTリンパ腫や特発性眼窩炎症(眼窩炎症性偽腫瘍)が重要である．ミクリッツ病の枠を超え，広く眼部に発生するIgG4関連疾患を取り扱える診断基準が望まれる．

IgG4-related disease sometimes affects the orbit.　Though IgG4-related Mikulicz's disease is recognized as typified, variant types are not uncommon, such as cases with unilateral lacrimal gland lesion and, on rare occasions IgG4＋ B cell can affect the orbital soft tissue without lacrimal gland lesions.　MALT lymphoma and idiopathic orbital inflammation are two important differential diagnoses.　Diagnosis of IgG4-related ophthalmologic disease must take into account various patterns of ophthalmic disease including Mikulicz's disease.