Spontaneous Regression of Swollen Submandibular Glands in IgG4-Related Disease.
Spontaneous Regression of Swollen Submandibular Glands in IgG4-Related Disease.
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DOI：
10.1177/2152656718816738
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发表时间：
2019-01
期刊：
影响因子：
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通讯作者：
Homma A
中科院分区：
文献类型：
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作者：
Suzuki M;Nakamaru Y;Takagi D;Honma A;Suzuki T;Takakuwa E;Morita S;Vreugde S;Homma A
IgG 4相关疾病是一种新的临床实体，经常与颌下腺（SMG）肿胀。未使用类固醇治疗的SMG肿胀的长期结局仍未知。检查在IgG 4相关疾病的背景下，肿胀的SMG是否在没有类固醇治疗的情况下自发消退，并确定可以预测SMG肿胀自发消退的生物标志物。通过测量计算机断层扫描的轴面和冠状面，计算49例诊断为IgG 4相关疾病的患者的SMG体积。通过治疗方案、临床数据和血清补体水平测量并检查SMG体积随时间的变化。我们发现49例IgG 4相关疾病患者中有28例（57%）SMG肿胀，其中20例（75%）SMG肿胀在未接受类固醇治疗的情况下消退。类固醇治疗组SMG肿胀消退所需的时间显著短于非类固醇治疗组。初次访视时，消退SMG组的血清补体成分显著低于未消退SMG组。我们观察到IgG 4相关疾病患者中75%的肿胀SMG自发消退。未接受类固醇治疗的患者肿胀SMG消退所需的时间长于接受类固醇治疗的患者。血清补体水平可作为IgG 4相关疾病患者肿胀SMG自发消退的预测因子。
IgG4-related disease is a new clinical entity frequently associated with swelling of the submandibular glands (SMGs). The long-term outcome of SMG swelling without steroid therapy remains unknown. To examine whether swollen SMGs spontaneously regress without steroid therapy in the context of IgG4-related disease and to identify biomarkers that can predict the spontaneous regression of SMG swelling. The SMG volume of 49 patients diagnosed with IgG4-related disease was calculated by measuring the axial and coronal planes of computed tomography scans. The change in SMG volume over time was measured and examined by treatment regimen, clinical data, and serum complement level. We found 28 of 49 (57%) IgG4-related disease patients to have swollen SMGs, with 15 of 20 (75%) of the swollen SMGs regressing without steroid therapy. The time required for the SMGs swelling to regress was significantly shorter in the steroid therapy group than in the no-steroid therapy group. Serum complement components at the initial visit were significantly lower in the regressed SMG group than in the nonregressed SMG group. We observed 75% of swollen SMGs spontaneously regressed in patients with IgG4-related disease. The time required for the swollen SMGs to regress was longer in patients without steroid therapy than in those with steroid therapy. Serum complement level could be used as a predictor for the spontaneous regression of swollen SMGs in patients with IgG4-related disease.