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Bilateral lacrimal gland disease: clinical features and outcomes
Eye ( IF 3.9 ) Pub Date : 2021-11-01 , DOI: 10.1038/s41433-021-01819-0
Sonia Huang 1 , Valerie Juniat 1 , Khami Satchi 2 , Liza M Cohen 3 , Garry Davis 1 , Daniel B Rootman 3 , Alan McNab 2, 4 , Dinesh Selva 1
Affiliation  

Background

Patients with bilateral lacrimal gland disease are a unique subset of patients where there is a paucity of literature. This presentation often represents systemic disease or malignancy and can cause diagnostic difficulties. We aim to describe the diagnoses and features of bilateral lacrimal gland disease.

Method

Retrospective multi-centre case series involving 115 patients with bilateral lacrimal gland disease from 1995 to 2020.

Results

115 patients were included. Their ages ranged from 9 to 85 (mean 47.3 years) with a female predominance (73, 63.5%). The most common category of diagnosis was inflammatory (69, 60%) followed by lymphoproliferative (23, 20%), structural (17, 14.8%) and other conditions (6, 5.2%). The five most common specific diagnoses were IgG4 related disease (20, 17.4%) and idiopathic orbital inflammatory disease (20, 17.4%), lymphoma (16, 13.9%), lacrimal gland prolapse (13, 11.3%), and sarcoidosis (11, 9.6%). Corticosteroid treatment was used most commonly (29, 25.2%) followed by observation (25, 21.7%). At last follow up, the majority of patients had complete resolution, significant improvement with mild residual disease or stable disease without further progression (104, 90.4%).

Conclusion

Bilateral lacrimal disease may be due to a range of aetiologies, most of which are systemic. The most common are inflammatory and lymphoproliferative conditions. Due to the wide range of aetiologies of bilateral lacrimal gland disease, it is extremely difficult to accurately determine a cause based on clinical findings alone, highlighting the vital role of lacrimal gland biopsy in patients presenting with bilateral lacrimal gland disease.



中文翻译:

双侧泪腺疾病:临床特征和结果

背景

双侧泪腺疾病患者是一个独特的患者亚群,缺乏文献。这种表现通常代表全身性疾病或恶性肿瘤,并可能导致诊断困难。我们旨在描述双侧泪腺疾病的诊断和特征。

方法

回顾性多中心病例系列研究,涉及 1995 年至 2020 年 115 例双侧泪腺疾病患者。

结果

包括 115 名患者。他们的年龄从 9 岁到 85 岁不等(平均 47.3 岁),其中女性占多数(73 岁,63.5%)。最常见的诊断类别是炎症(69, 60%),其次是淋巴增生(23, 20%)、结构(17, 14.8%)和其他疾病(6, 5.2%)。五种最常见的特异性诊断是 IgG4 相关疾病(20, 17.4%)和特发性眼眶炎症(20, 17.4%)、淋巴瘤(16, 13.9%)、泪腺脱垂(13, 11.3%)和结节病(11 , 9.6%)。最常使用皮质类固醇治疗 (29, 25.2%),其次是观察 (25, 21.7%)。末次随访时,大部分患者完全消退、显着改善,有轻度残留病灶或病情稳定且无进一步进展(104,90.4%)。

结论

双侧泪道疾病可能是由多种病因引起的,其中大多数是全身性的。最常见的是炎症和淋巴增殖性疾病。由于双侧泪腺疾病的病因广泛,仅根据临床发现很难准确确定病因,这凸显了泪腺活检在双侧泪腺疾病患者中的重要作用。

更新日期:2021-11-02
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