Relapsed IgG4-related dacryoadenitis and sialoadenitis, so called Mikulicz's disease: A case report

Mikulicz's disease is a systemic IgG4-related condition that has recently been referred to as IgG4-related dacryoadenitis and sialoadenitis. We describe relapsed IgG4-related dacryoadenitis and sialoadenitis, so called Mikulicz's disease in a 69-year-old man who was administered with prednisolone (40 mg/day) during March 2007. The dosage was tapered to 0.5 mg/day over a period of 2 years with observation of the patient's clinical course. However, the bilateral submandibular and parotid glands became swollen in July 2009. A whole-body examination revealed no other illnesses or complications. A biopsy of the submandibular gland revealed IgG4-positive plasma cells. Relapsed Mikulicz's disease was diagnosed and the patient was started on prednisolone (40 mg/day) again. At the time of writing, the patient is being maintained on 7 mg/day of prednisolone.