Change of Serum IgG4 in Patients with Ocular Adnexal Marginal Zone B Cell Lymphoma Associated with IgG4-Related Ophthalmic Disease After Treatment

J Ocul Pharmacol Ther. 2017 Sep;33(7):543-548. doi: 10.1089/jop.2016.0175. Epub 2017 May 17.

Abstract

Purpose: To investigate the change of serum IgG4 concentrations correlated with clinical evolution in patients with ocular adnexal marginal zone B cell lymphoma associated with IgG4-related ophthalmic disease (IgG4-ROD).

Methods: Three consecutive patients with histopathologically confirmed ocular adnexal marginal zone B cell lymphoma associated with IgG4-ROD were evaluated. Two patients received radiotherapy and 1 patient received steroid therapy. Treatment outcome was evaluated by clinical symptoms, radiologic examination, and change of serum IgG4 level in these patients.

Results: All patients had elevated serum IgG4 before treatment (462, 338, and 780 mg/dL respectively.) The 2 patients who received radiotherapy achieved complete remission and the serum IgG4 decreased to 345 and 92 mg/dL, respectively. The patient who underwent systemic steroid achieved partial remission and the serum IgG4 decrease to 161 mg/dL.

Conclusion: Our study showed elevated serum IgG4 in all patients with ocular adnexal marginal zone B cell lymphoma associated with IgG4-ROD. In addition, the elevated serum IgG4 may decrease or keep stable after treatment, accompanied by improvement in clinical symptoms and reduction of lesions.

Keywords: IgG4; lymphoma; ocular adnexa; radiotherapy; steroid.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Autoimmune Diseases / blood*
  • Autoimmune Diseases / pathology
  • Autoimmune Diseases / therapy
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulin G / blood*
  • Lymphoma, B-Cell, Marginal Zone / blood*
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • Lymphoma, B-Cell, Marginal Zone / therapy
  • Male
  • Multimodal Imaging
  • Orbital Neoplasms / blood*
  • Orbital Neoplasms / pathology
  • Orbital Neoplasms / therapy
  • Positron-Emission Tomography
  • Radiotherapy
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids
  • Immunoglobulin G