Serologic factors in early relapse of IgG4-related orbital inflammation after steroid treatment

Purpose: To determine whether serologic factors correlate with early relapse in cases of IgG4-related orbital inflammation, a lymphoproliferative disorder. Design: Retrospective cohort study. Methods: We examined the orbital images and serum data of 30 patients with (n = 24) or without (n = 6) corticosteroid treatment before and after corticosteroid treatment and 6 months after discontinuation of corticosteroid treatment. Results: Seven patients (23%) (all with corticosteroid treatment) had elevated serum levels of rheumatoid factor. Of the 24 patients with corticosteroid treatment, 24 (100%) showed regression of the lesion, but 8 of the 24 (33%) showed relapse. The serum IgG4 levels before and after corticosteroid treatment were not significantly different between the relapsed and nonrelapsed groups (P =.5 and P =.2, respectively). However, the incidence of patients who were rheumatoid factor-positive was significantly higher in the relapsed group (P =.02). The 6 patients without corticosteroid treatment showed minor proliferation or regression of the lesion at the 6-month follow-up. Conclusions: The serum rheumatoid factor level may correlate with proliferative activity in IgG4-related orbital inflammation.