The clinical characteristics of patients with IgG4-related disease with infiltration of the labial salivary gland by IgG4-positive cells
The clinical characteristics of patients with IgG4-related disease with infiltration of the labial salivary gland by IgG4-positive cells
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DOI：
10.3109/14397595.2014.891964
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发表时间：
2014-11-01
影响因子：
2.2
通讯作者：
Himi, Tetsuo
中科院分区：
文献类型：
--
作者：
Abe, Ayumi;Takano, Kenichi;Himi, Tetsuo
目标.米库利奇病（MD）是一种免疫球蛋白（IG）G4相关疾病，具有全身症状。对于可能与IgG 4相关的MD患者，建议进行颌下腺（SMG）活检，以进行准确的鉴别诊断;然而，某些患者很难进行此手术。相比之下，唇唾液腺（LSG）活检更方便。在这里，我们对LSG样本中浸润了丰富的IgG 4阳性浆细胞的IgG 4相关MD患者进行了分析。方法。16例诊断为IgG 4相关MD的患者同时进行SMG和LSG活检。我们评估了患者的血清学和F-18-氟-2-脱氧葡萄糖-正电子发射断层扫描/计算机断层扫描（F-18-FDG-PET/CT），并将其分为LSG +（LSG标本中IgG 4阳性浆细胞/IgG阳性浆细胞>40%，11例患者）或LSG -（LSG标本中IgG 4阳性浆细胞/IgG阳性浆细胞>40%，6例患者）。两组间血清IgG和IgG 4水平无显著差异，但LSG +组血清可溶性白细胞介素-2受体（sIL-2 R）浓度显著升高。所有腮腺F-18-FDG摄取增加的患者均属于LSG +组。当SMG活检不可能时，血清sIL-2 R浓度和F-18-FDGPET/ CT结果可预测LSG活检是否有助于IgG 4相关MD的诊断。
Objectives. Mikulicz's disease (MD) is an immunoglobulin (Ig) G4-related disease with systemic symptoms. Submandibular gland (SMG) biopsy is recommended for patients with possible IgG4-related MD for accurate differential diagnosis; however, it is difficult for certain patients to undergo this procedure. In contrast, labial salivary gland (LSG) biopsy is more convenient. Here we present an analysis of patients with IgG4-related MD whose LSG specimens were infiltrated with abundant IgG4-positive plasma cells.Methods. Sixteen patients diagnosed with IgG4-related MD underwent simultaneous SMG and LSG biopsies. We evaluated patients' serological and F-18-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (F-18-FDG-PET/CT) and grouped them as LSG + (LSG specimens with >40% IgG4-positive plasma cells/IgG-positive plasma cells, 11 patients) or LSG - (LSG specimens with >40% IgG4-positive plasma cells/IgG-positive plasma cells, 6 patients).Results. There were not significant differences in serum IgG and IgG4 levels between the two groups; however, serum concentrations of soluble interleuikin-2 receptor (sIL-2R) were significantly higher in the LSG + group. All patients with increased F-18-FDG uptake in their parotid glands were a part of the LSG + group.Conclusions. When a SMG biopsy is not possible, the serum concentration of sIL-2R and F-18-FDGPET/ CT findings may predict whether LSG biopsy will facilitate the diagnosis of IgG4-related MD.