Idiopathic sclerosing inflammation of the orbit: A case of steroid-responsive disease in a patient with autoimmune hemolytic anemia

Purpose: Idiopathic sclerosing orbital inflammation (ISOI) has been categorized by some authors as a unique clinicopathologic entity, separate from the heterogenous group of disorders known collectively as nonspecific orbital inflammation. Histologic similarity and clinical association with other fibrosclerosing conditions has been shown. The authors present a case of ISOI in conjunction with autoimmune hemolytic anemia. Methods: A 59-year-old woman with a history of hemolytic anemia had left upper lid swelling, periocular pain, proptosis, and restriction of ocular motility. Magnetic resonance imaging (MRI) showed a homogenously enhancing lateral orbital mass. Biopsy revealed dense fibrous connective tissue with a paucicellular infiltrate, consistent with ISOI, and treatment with prednisolone 60 mg/day was instituted. Results: At 4-week review, the proptosis had settled and the patient regained full range of extraocular movements. At 14 months, the response was sustained and repeat MRI showed a 70% reduction in size of the mass. Conclusions. The first known case of ISOI and hemolytic anemia is presented. Despite dense fibrosis histologically, steroid responsiveness can be encountered in cases of ISOI. An early, aggressive approach to management is recommended, and corticosteroids should be considered as a treatment option.K.J. Billing, J. Hsuan and D. Selv

A Selective Review of Recent Developments in the Economic Growth Literature

The role of institutions in the process of economic growth and development has generated considerable interest among researchers over the past few decades. In particular, incorporating institutional variables into the established growth theories and empirics involves understanding the impact and mechanisms through which institutions affect growth. In surveying recent developments in the economic growth literature, this review pays attention to the resurgent institutionalist research trend and its implications for growth theory and empirical research on growth. Policy issues primarily focused on Asian Pacific developing countries are highlighted. Copyright © 2007 The Author Journal compilation © 2007 Crawford School of Economics and Government, The Australian National University and Blackwell Publishing Asia Pty Ltd. .