Please use this identifier to cite or link to this item: https://ir.swu.ac.th/jspui/handle/123456789/14410
ชื่อเรื่อง: Surgical debulking for idiopathic dacryoadenitis: A diagnosis and a cure
ผู้แต่ง: Mombaerts I.
Cameron J.D.
Chanlalit W.
Garrity J.A.
Keywords: corticosteroid
dexamethasone
immunoglobulin G4
methotrexate
methylprednisolone
rituximab
triamcinolone
adolescent
adult
aged
Article
clinical article
clinical feature
corticosteroid therapy
cytoreductive surgery
dacryocystitis
drug megadose
female
histopathology
human
human tissue
idiopathic disease
immunohistochemistry
low drug dose
male
multicenter study (topic)
nuclear magnetic resonance imaging
treatment outcome
Adolescent
Adult
Aged
Child
Dacryocystitis
Female
Follow-Up Studies
Humans
Lacrimal Apparatus
Magnetic Resonance Imaging
Male
Middle Aged
Ophthalmologic Surgical Procedures
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
วันที่เผยแพร่: 2014
บทคัดย่อ: Purpose Idiopathic inflammatory tumor of the lacrimal gland, also called idiopathic dacryoadenitis, generally is treated with high-dose, long-term systemic corticosteroids, despite their limited success, high recurrence rate, and incidence of drug-induced side effects. This study describes the outcome of patients with idiopathic dacryoadenitis who were managed with surgical debulking. Design Retrospective case series from 2 tertiary referral centers. Participants Forty-six patients (46 lacrimal glands). Methods Review of the clinical records, radiologic scans, and histopathologic specimens, with additional immunoglobulin G4 immunostaining. Main Outcome Measures Clinical signs and symptoms at 2 months after the surgery and off medications. Results Before referral, 41% (19 of 46) of the patients had received systemic high-dose corticosteroids, after which they all showed recurrence, of whom 26% (5 of 19) became dependent on corticosteroids. At referral, all patients underwent debulking surgery of the inflammatory lacrimal gland mass for diagnostic and therapeutic reasons. Additionally, intralesional or systemic low-dose corticosteroids were given during the operation or the first postoperative days in 54% (25 of 46) of the patients. At 2 months after the debulking surgery, a full clinical recovery was seen in 80% (37 of 46) of the patients. A recurrence occurred in 8% (3 of 37) of the patients 4 months and 2.2 and 4.6 years later. Surgical failure (20%; 9 of 46) was correlated with prior corticosteroid treatment (P = 0.002, Fisher exact test), but not with sclerosing inflammation present in 28% (13 of 46). The median follow-up time was 7.2 years (range, 0.7-18 years). Conclusions Debulking biopsy procedures for idiopathic dacryoadenitis, in addition to being diagnostic, may be therapeutic. © 2014 by the American Academy of Ophthalmology Published by Elsevier Inc.
URI: https://ir.swu.ac.th/jspui/handle/123456789/14410
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84895069037&doi=10.1016%2fj.ophtha.2013.09.010&partnerID=40&md5=e7b2855f1d367ae7501bb7955d6016e1
ISSN: 1616420
Appears in Collections:Scopus 1983-2021

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