Ocular Adnexal IgG4-Related Lymphoplasmacytic Infiltrative Disorder
Ocular Adnexal IgG4-Related Lymphoplasmacytic Infiltrative Disorder
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DOI：
10.1001/archophthalmol.2010.45
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发表时间：
2010-05-01
影响因子：
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通讯作者：
Terasaki, Hiroko
中科院分区：
文献类型：
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作者：
Kubota, Toshinobu;Moritani, Suzuko;Terasaki, Hiroko
目的：为了确定IgG 4阳性浆细胞浸润患者的临床病理学特征到眼附属器。方法：我们设计了一项前瞻性研究，以评估24例眼附属器淋巴浆细胞浸润性病变，包括硬化性炎症和反应性淋巴样增生。我们分析了所有患者的外周血和活检标本。放置在IgG 4相关组的分类标准包括有一个升高的血清水平的IgG 4的135 mg/dL或更高和IgG 4：IgG的比例浸润浆细胞的30%或更高。结果：10例患者符合分类标准（IgG 4相关组），9例患者不符合标准（IgG 4无关组），和5例患者符合1，但不是两个标准（不确定组）。IgG 4相关组患者双侧受累显著较高（P = 0.02），过敏性疾病较多（P = 0.01），血清IgE水平升高（P = 0.01）。在IgG 4相关组的10例患者中，3例也有多克隆高丙种球蛋白血症，6例有全身淋巴结病或唾液腺肿大，1例发生自身免疫性胰腺炎。在IgG 4无关组的患者没有这些血清和/或全身abnormals.Conclusion：IgG 4相关和IgG 4无关组有不同的模式的组织参与和全身性疾病协会和可能不同的疾病。
Objective: To determine the clinicopathological characteristics of patients with infiltration of IgG4-positive plasma cells into the ocular adnexa.Methods: We designed a prospective study to evaluate 24 patients with ocular adnexal lymphoplasmacytic infiltrative lesions, including sclerosing inflammation and reactive lymphoid hyperplasia. We analyzed peripheral blood and biopsy specimens from all patients. The classification criteria for placement in the IgG4-related group included having both an elevated serum level of IgG4 of 135 mg/dL or greater and an IgG4:IgG ratio of infiltrating plasma cells of 30% or greater.Results: Ten patients met the classification criteria (IgG4-related group), 9 patients did not meet the criteria (IgG4-unrelated group), and 5 patients met 1 but not both criteria (indeterminate group). Patients in the IgG4-related group had significantly higher bilateral involvement (P = .02), a higher number of allergic diseases (P = .01), and elevated IgE serum levels (P = .01). Of the 10 patients in the IgG4-related group, 3 also had polyclonal hypergammaglobulinemia, 6 had systemic lymphadenopathy or salivary gland enlargement, and 1 developed autoimmune pancreatitis. Patients in the IgG4-unrelated group did not have these serum and/or systemic abnormalities.Conclusion: The IgG4-related and IgG4-unrelated groups have different patterns of tissue involvement and systemic disease associations and possibly different prognoses.