FAMILY HEALTH

NEUROLOGY

55 yr Female presented with progressive swelling of bilateral parotid region, bilateral periorbital edema since 7 months
On examination- b/l parotid swelling
Usg Parotid- b/l parotid bulky, altered echotexture with few necrotic lymph nodes
Fnac LN- Lymphocyte predominant infiltration
MRI Orbit- B/L Extra ocular ms bulky, b/l lacrimal gland enlargement,  b/l parotid gland enlargement with enlarged LN rt>left 
Thyroid profile- WNL
s. IgG4 levels were advised and found to be - 254 mg/dL(elevated) Final Diagnosis- IgG4 Related disease