Unveiling the Uncommon: A Case Study on Adult-Onset Asthma Coexisting with Periorbital Xanthogranuloma

Eyelid and orbital lesions with asthma are the hallmarks of adult-onset asthma and periocular Xanthogranuloma (AAPOX). We present a rare case of an adult female diagnosed with AAPOX proven by biopsy with an elevated IgG4 serum level, showing a possible association between the two diseases. A 60-year-old female presented to the out-patient department of Khyber Teaching Hospital with the chief complaint of bilateral yellow, painless, upper eyelid swellings for the past 5 years. She had been treated for tuberculosis 15 years ago and was diagnosed with asthma 15 years ago, when she was 45 years old. She had history of chronic sinusitis. The patient had an elevated serum human IgG4 level of 874 mg/L. Anterior orbitotomy was performed. On the basis of histopathology, the diagnosis of adult-onset asthma and periocular xanthogranuloma was confirmed. AAPOX, though rare, is a significant cause of orbital lesions.