IgG4-related disease: a contemporary review
H Karadeniz, A Vaglio - Turkish Journal of Medical Sciences, 2020 - journals.tubitak.gov.tr
Turkish Journal of Medical Sciences, 2020•journals.tubitak.gov.tr
Background/aim: Immunoglobulin G4-related disease (IgG4-RD), is an immune-mediated
fibroinflammatory condition, which may involve multiple organs and mostly presents with
high serum IgG4 levels and specific histopathological characteristics. As IgG4-RD is a
relatively new entity the etiology, prevalence and epidemiologic knowledge is quite limited.
Although involvement of almost all anatomical regions has been reported, the most
commonly affected regions are pancreas, lacrimal glands, salivary glands, retroperitoneum …
fibroinflammatory condition, which may involve multiple organs and mostly presents with
high serum IgG4 levels and specific histopathological characteristics. As IgG4-RD is a
relatively new entity the etiology, prevalence and epidemiologic knowledge is quite limited.
Although involvement of almost all anatomical regions has been reported, the most
commonly affected regions are pancreas, lacrimal glands, salivary glands, retroperitoneum …
Abstract
Background/aim: Immunoglobulin G4-related disease (IgG4-RD), is an immune-mediated fibroinflammatory condition, which may involve multiple organs and mostly presents with high serum IgG4 levels and specific histopathological characteristics. As IgG4-RD is a relatively new entity the etiology, prevalence and epidemiologic knowledge is quite limited. Although involvement of almost all anatomical regions has been reported, the most commonly affected regions are pancreas, lacrimal glands, salivary glands, retroperitoneum, orbita, lymph nodes, kidney and lungs. Diagnosis is made with combined evaluation of clinical, radiological and histopathological findings. Typical histopathological features include storiform fibrosis, dense lymphoplasmacytic infiltrates and obliterative phlebitis. Its course is typically marked by remission and relapsing attacks and it may lead to fibrosis, destructive lesions in tissues and organ failure unless promptly treated. In the treatment of IgG4-RD, many approaches including surgical resection of tissues, systemic glucocorticoids, steroid-sparing immunosuppressive drugs, and biological agents are employed. Although association is not clear, malignancies are frequently reported in IgG4-RD patients. Therefore, it is prudent to monitor patients for the symptoms of malignant diseases. Conclusion: In this review, recent advances in clinico-pathological characteristics, diagnosis, and treatment of IgG4-RD are discussed.
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