IgG4 orbitopathy: unravelling a multisystem diagnostic challenge

Sir, Immunoglobulin-G4-related disease (IgG4RD) is a newly emerging clinical entity presenting clinicians with a diagnostic challenge, due to simultaneous or sequential involvement of multiple organs. We present a case of a patient who initially underwent extensive and invasive investigations to determine the cause of bilateral cervical lymphadenopathy, before an orbital biopsy finally provided a definitive diagnosis. She was successfully treated with corticosteroids, with a dramatic and rapid response.