We read with interest the article by Takahira and colleagues on IgG4-related chronic sclerosing dacryoadenitis.1 We have previously studied the clinicopathologic features of 6 patients with IgG4-related chronic sclerosing dacryoadenitis with elevated serum IgG4 and morphologic features identical to those described by the authors.2 Three patients in our series satisfied the clinical criteria of Mikulicz disease (cases 2, 4, and 5), whereas 3 presented with unilateral or bilateral lacrimal swelling alone. Thus while IgG4-related chronic sclerosing dacryoadenitis is responsible for some cases of Mikulicz disease, some of these patients do not have Mikulicz disease.
Cheuk W, Yuen HKL, Chan JKC. Complication of IgG4-Related Chronic Sclerosing Dacryoadenitis by Lymphoma. Arch Ophthalmol. 2008;126(8):1170. doi:10.1001/archopht.126.8.1170-a