Grados A, Ebbo M, Jean E, Bernit E, Harlé J-R, Schleinitz N
Service de médecine interne, hôpital de la Timone, AP-HM, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille, France.
Service de médecine interne, hôpital de la Timone, AP-HM, Aix-Marseille université, 264, rue Saint-Pierre, 13385 Marseille, France.
Rev Med Interne. 2015 Jun;36(6):395-404. doi: 10.1016/j.revmed.2014.11.007. Epub 2015 Jan 13.
IgG4-related disease is an inflammatory disorder characterized by a polyclonal lymphoplasmacytic tissue infiltrate, with numerous IgG4+ plasmocytes, evolving toward fibrosis. The disease is heterogeneous and affects several tissues and organs synchroneously or metachroneously. Both the fibrosis and the tumor forming characteristics of the disease can be responsible of irreversible tissue damage. For these reasons treatment is usually necessary. A dramatic response is usually observed with steroid treatment but relapses are frequent. Immunosuppressive agents and rituximab are used as second line treatments. We review here previous studies on treatment and suggest general recommendations for the treatment and follow up of patients with IgG4-related disease.
IgG4相关疾病是一种炎症性疾病,其特征为多克隆淋巴细胞浆细胞组织浸润,伴有大量IgG4+浆细胞,并逐渐发展为纤维化。该疾病具有异质性,可同时或先后累及多个组织和器官。疾病的纤维化和肿瘤形成特征均可导致不可逆的组织损伤。因此,通常需要进行治疗。类固醇治疗通常会观察到显著疗效,但复发频繁。免疫抑制剂和利妥昔单抗用作二线治疗。我们在此回顾以往关于治疗的研究,并对IgG4相关疾病患者的治疗和随访提出一般性建议。