Al-Mujaini Abdullah, Al-Khabori Murtadha, Shenoy Kashinatha, Wali Upender
Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Hematology, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Muscat, Oman.
Oman Med J. 2018 Mar;33(2):97-103. doi: 10.5001/omj.2018.20.
Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognized immune-mediated condition comprised of a collection of disorders that share specific pathological, serological, and clinical features. IgG4-RD is a fibroinflammatory condition with a tendency to form tumors with inflammatory infiltrate with IgG4 rich plasma cells and elevation of serum IgG4, which may affect virtually every organ and tissue. IgG4-related ophthalmic disease may present as dacryoadenitis, myositis, or involvement of other orbital tissue. Hypophysitis or pachymeningitis may manifest as cranial neuropathies. The diagnosis of IgG4-RD is based on a typical clinical scenario, supportive laboratory test, expected radiological characteristics, and distinct histopathological and immunohistochemical features. Corticosteroids and immunosuppressives form the mainline treatment.
免疫球蛋白G4相关疾病(IgG4-RD)是一种越来越被认识到的免疫介导性疾病,由一系列具有特定病理、血清学和临床特征的病症组成。IgG4-RD是一种纤维炎症性疾病,倾向于形成伴有富含IgG4浆细胞的炎症浸润的肿瘤,并导致血清IgG4升高,几乎可累及每个器官和组织。IgG4相关眼病可表现为泪腺炎、肌炎或其他眼眶组织受累。垂体炎或硬脑膜炎可表现为颅神经病变。IgG4-RD的诊断基于典型的临床情况、支持性实验室检查、预期的放射学特征以及独特的组织病理学和免疫组化特征。皮质类固醇和免疫抑制剂是主要治疗方法。