Visual impairment in immunoglobulin G4-related disease: A case report

The present study reports on the case of a 50-year-old male with sinusitis, diplopia, secretory otitis media and skin eczema for >14 years. The patient presented with visual impairment in both eyes and subxiphoid pain on admission to the First Affiliated Hospital of China Medical University (Shenyang, China). Orbital CT revealed a slightly thickened left inferior rectus muscle. Due to a periocular mass, enlarged lymph nodes, elevated serum immunoglobulin G4 (IgG4) levels and enriched IgG4-positive plasma cells in the lymph nodes, the diagnosis of IgG4-related disease (IgG4-RD), possibly involving at least 10 organs, was established. Following treatment with methylprednisolone, the serum IgG4 levels decreased to normal and binocular vision returned to normal. Unlike previously reported cases, the present case exhibited no swollen masses around the optic nerve. The purpose of the present case report was to improve the understanding of IgG4-RD.