IgG4-related disease involving facial, infraorbital, auriculotemporal and optic nerves: multinervous cranial involvement in an adult patient.
Fadoua El Mourabit, Maryam Elazouani
✦ AI-curated · Sources linked
Case in brief
A man in his mid-40s presented with rapidly progressive orbital symptoms initially diagnosed as orbital cellulitis. Despite treatment, his condition deteriorated, leading to multiple cranial nerve involvement. MRI showed an infiltrative process affecting the optic, infraorbital, facial, and auriculotemporal nerves. Histopathology confirmed IgG4-related disease, and the patient improved significantly with corticosteroid therapy.
What made this case unusual
The case exemplifies IgG4-related disease presenting as orbital cellulitis, which can lead to misdiagnosis and inappropriate management.
Diagnostic / clinical pearl
Clinicians should consider IgG4-related disease in patients with atypical orbital symptoms and multiple cranial nerve involvement, especially when initial treatments fail.
Why it matters
Early recognition of IgG4-RD can prevent unnecessary surgeries and reduce the risk of irreversible neurological damage.