Ilse Mombaerts1. 1. Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium.
Abstract
PURPOSE OF REVIEW: To review the spectrum of lacrimal gland inflammation, with particular reference to the old condition, idiopathic dacryoadenitis, and the new, immunoglobulin G4 (IgG4)-related dacryoadenitis. RECENT FINDINGS: Idiopathic dacryoadenitis remains the most common inflammatory lesion of the lacrimal gland, for which surgical treatment is successful. There is mounting evidence that the presence of IgG4-positive plasma cells in a lacrimal gland specimen is nonspecific, for being found in other inflammatory lacrimal gland lesions, even lymphoproliferative ones. To identify IgG4-related dacryoadenitis, particularly when there is no documented disease elsewhere, the criteria have been strengthened toward abundant IgG4-positive plasma cell counting. SUMMARY: The gold standard of diagnosis of noninfectious lacrimal gland inflammation is tissue biopsying, which is commonly therapeutic in the case of idiopathic dacryoadenitis. Although it was initially suggested that IgG4-related dacryoadenitis is a possible cause of idiopathic dacryoadenitis, it becomes obvious that it has more resemblance to the lymphoproliferative tumors.
PURPOSE OF REVIEW: To review the spectrum of lacrimal gland inflammation, with particular reference to the old condition, idiopathic dacryoadenitis, and the new, immunoglobulin G4 (IgG4)-related dacryoadenitis. RECENT FINDINGS:Idiopathic dacryoadenitis remains the most common inflammatory lesion of the lacrimal gland, for which surgical treatment is successful. There is mounting evidence that the presence of IgG4-positive plasma cells in a lacrimal gland specimen is nonspecific, for being found in other inflammatory lacrimal gland lesions, even lymphoproliferative ones. To identify IgG4-related dacryoadenitis, particularly when there is no documented disease elsewhere, the criteria have been strengthened toward abundant IgG4-positive plasma cell counting. SUMMARY: The gold standard of diagnosis of noninfectious lacrimal gland inflammation is tissue biopsying, which is commonly therapeutic in the case of idiopathic dacryoadenitis. Although it was initially suggested that IgG4-related dacryoadenitis is a possible cause of idiopathic dacryoadenitis, it becomes obvious that it has more resemblance to the lymphoproliferative tumors.
Authors: James T Rosenbaum; Dongseok Choi; Christina A Harrington; David J Wilson; Hans E Grossniklaus; Cailin H Sibley; Sherveen S Salek; John D Ng; Roger A Dailey; Eric A Steele; Brent Hayek; Caroline M Craven; Deepak P Edward; Azza M Y Maktabi; Hailah Al Hussain; Valerie A White; Peter J Dolman; Craig N Czyz; Jill A Foster; Gerald J Harris; Youn-Shen Bee; David T Tse; Chrisfouad R Alabiad; Sander R Dubovy; Michael Kazim; Dinesh Selva; R Patrick Yeatts; Bobby S Korn; Don O Kikkawa; Rona Z Silkiss; Jennifer A Sivak-Callcott; Patrick Stauffer; Stephen R Planck Journal: JAMA Ophthalmol Date: 2017-11-01 Impact factor: 7.389