UNASSIGNED: A 53-year-old male patient started to receive anti-IL-5 receptor alpha chain antibody to treat eosinophilic sinusitis and eosinophilic severe bronchial asthma. Several months later, proliferative changes of the right palpebral conjunctiva appeared and were treated with tacrolimus and betamethasone eye drops. However, the findings gradually worsened and the right upper palpebral conjunctiva remained exposed. Exposed tissue was resected and histopathological examinations revealed the presence of IgG4 positive cells (10>/400HPF). Anti-IL-5 receptor alpha chain antibody treatment was stopped and changed to prednisolone. The findings improved and anti-IL-4 receptor alpha chain antibody was added to control eosinophilic sinusitis and eosinophilic severe bronchial asthma. The lesions worsened when the prednisolone was reduced under treatment with anti-IL-4 receptor alpha-chain antibody.
UNASSIGNED: In this case, the proliferative changes could not be suppressed by treatment targeting IL-5R receptor alpha-chain and IL-4R receptor alpha-chain, suggesting that the patient had VKC-like severe allergic conjunctivitis as a manifestation of IgG4-related disease. Additionally, it should be noted that if the severe conjunctivitis cannot be suppressed by treatment with immunosuppressive eye drops or various systemic biological agents, the conjunctivitis may be a manifestation of IgG4 related disease.
UNASSIGNED:一名53岁男性患者开始接受抗IL-5受体α链抗体治疗嗜酸性粒细胞性鼻窦炎和嗜酸性粒细胞性重症支气管哮喘。几个月后,右睑结膜出现增生性改变,用他克莫司和倍他米松滴眼液治疗。然而,结果逐渐恶化,右上睑结膜仍然暴露。切除暴露的组织,组织病理学检查显示存在IgG4阳性细胞(10>/400HPF)。停止抗IL-5受体α链抗体医治并变更为泼尼松龙。该发现改善了抗IL-4受体α链抗体,用于控制嗜酸性粒细胞性鼻窦炎和嗜酸性粒细胞性重症支气管哮喘。当泼尼松龙在抗IL-4受体α链抗体治疗下减少时,病变恶化。
UNASSIGNED:在这种情况下,通过靶向IL-5R受体α链和IL-4R受体α链的治疗不能抑制增殖变化,提示患者患有VKC样严重过敏性结膜炎,表现为IgG4相关疾病.此外,应该注意的是,如果用免疫抑制滴眼液或各种全身生物制剂治疗不能抑制严重的结膜炎,结膜炎可能是IgG4相关疾病的表现。