양측 눈꺼풀 결막에 국한되어 발생한 면역글로불린 G4 관련 안질환

Isolated Bilateral Tarsal Conjunctival Immunoglobulin G4-related Ophthalmic Disease

Purpose: To report a case of isolated bilateral tarsal conjunctival immunoglobulin G4 (IgG4)-related ophthalmic disease. Case summary: A 34-year-old male presented with both upper tarsal mass refractory with medical treatment at local hospital from 4 months ago. Slit-lamp examination showed elevated multi-lobular masses on both upper tarsal conjunctiva. Immunochemical stain on specimen showed the ratio of the IgG4+ to IgG+ cells was approximately over 80% and the mean number of IgG4-positive plasma cells was over 100 per high-power field. Therefore, we could finally diagnose his illness as IgG4-related ophthalmic disease. There was no evidence of systemic involvement in other examinations such as blood tests or radiologic examination performed in the rheumatology department of internal medicine. Conclusions: IgG4-related ophthalmic disease is well known to occur in the orbit, especially in the lacrimal gland. However, there are no reported cases of tarsal conjunctival IgG4-related ophthalmic disease in Korea. Therefore, if a tumor is found in the tarsal conjunctiva, appropriate pathologic examination should be performed with the possibility of IgG4-related ophthalmic disease.