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[米库利奇病中疾病独立性的意义——对米库利奇病兴趣的复苏]

[The significance of disease-independence in Mikulicz's disease--revival interests in Mikulicz's disease].

作者信息

Yamamoto Motohisa, Suzuki Chisako, Naishiro Yasuyoshi, Takahashi Hiroki, Shinomura Yasuhisa, Imai Kohzoh

机构信息

First Department of Internal Medicine, Sapporo Medical University School of Medicine.

出版信息

Nihon Rinsho Meneki Gakkai Kaishi. 2006 Feb;29(1):1-7. doi: 10.2177/jsci.29.1.

Abstract

Mikulicz's disease represents a unique condition involving enlargement of the lacrimal and salivary glands. Mikulicz's disease has been considered part of primary Sjögren's syndrome because both diseases were histologically similar. However, the gland swellings in Mikulicz's disease are persistent, and its decreased secretional function is good responsiveness to glucocorticoid. Serologically, Mikulicz's disease is characterized by few autoantibody including anti-SS-A and anti-SS-B antibodies. Recently, it is revealed elevated IgG4 concentrations in the serum and prominent infiltration by plasmacytes expressing IgG4 in the lacrimal and salivary glands in Mikulicz's disease. Prominent IgG4-positive plasma cells are also detected in systemic lymph tissues. We cannot detect the phenomenon in Sjögren's syndrome. In complications with Mikulicz's disease, there are autoimmune pancreatitis, retroperitoneal fibrosis, tubulointerstitial nephritis, autoimmune hypophysitis, Riedel's thyroiditis, which are related to IgG4 in its pathogenesis. Mikulicz's disease is different from Sjögren's syndrome, and may be a systemic IgG4-related plasmacytic disease.

摘要

米库利奇病是一种涉及泪腺和唾液腺肿大的独特病症。米库利奇病曾被认为是原发性干燥综合征的一部分,因为这两种疾病在组织学上相似。然而,米库利奇病中的腺体肿大是持续性的,其分泌功能减退对糖皮质激素有良好反应。在血清学方面,米库利奇病的特征是自身抗体较少,包括抗SS - A和抗SS - B抗体。最近发现,米库利奇病患者血清中IgG4浓度升高,泪腺和唾液腺中有大量表达IgG4的浆细胞浸润。在全身淋巴组织中也可检测到大量IgG4阳性浆细胞。而在干燥综合征中未发现此现象。米库利奇病的并发症包括自身免疫性胰腺炎、腹膜后纤维化、肾小管间质性肾炎、自身免疫性垂体炎、里德尔甲状腺炎,这些并发症在发病机制上与IgG4相关。米库利奇病与干燥综合征不同,可能是一种全身性IgG4相关的浆细胞病。

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