IgG4 相关疾病：慢性鼻-鼻窦炎与全身症状的关联。
IgG4-related disease: association between chronic rhino-sinusitis and systemic symptoms.
机构信息
Department of Rheumatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
出版信息
Eur Arch Otorhinolaryngol. 2018 Aug;275(8):2013-2019. doi: 10.1007/s00405-018-5013-5. Epub 2018 Jun 8.
PURPOSE
The objective of this study is to analyze the relationship between chronic rhino-sinusitis (CRS) and systemic symptoms in patients with IgG4-related disease (IgG4-RD).
PATIENTS AND METHODS
The patients with IgG4-RD, confirmed by restrict association with clinical and histopathological manifestations between March 2013 and July 2016, were enrolled and followed-up for 1 year at the Tongren Hospital, Capital Medical University. The patients were divided into two groups: the case group included IgG4-RD patients with CRS confirmed by clinical and imaging, while the control group included IgG4-RD patients without CRS confirmed by clinical and imaging. Age, gender, clinical manifestations, the percentage of eosinophils in peripheral blood, sedimentation (ESR), C-reaction protein, serum IgE and IgG4 levels, histopathology, and treatment drugs at the baseline and 1 year of follow-up were compared between the two groups.
RESULTS
A total of 46 cases met the diagnostic criteria for IgG4-RD. A total of 30 patients (65.2%) had IgG4-RD complicated with CRS, and were aged 49.7 ± 13.4 years, with male:female ratio = 2:1. The disease duration in the case group was longer than that in the control group (3.0 versus 0.8, p = 0.009). The ratio of ocular involvement was higher (86.7 versus 60%, p < 0.001), and allergic manifestations including drug allergy, asthma, and allergic skin were more common (56.5 versus 20%, p = 0.004), with a higher percentage of eosinophils in peripheral blood (8.5 versus 3.3%, p = 0.018) and more sensitive to glucocorticoids (6.0 versus 3.5, p = 0.004) than those in the control group.
CONCLUSIONS
CRS in patients with IgG4-RD was closely associated with IgG4-related ocular lesions, which was more prone to allergic manifestations accompanied by raised percentage of eosinophils in peripheral blood. The treatment of patients with IgG4-RD complicated with CRS was more effective than those with IgG4-RD without CRS.
目的
本研究旨在分析 IgG4 相关疾病（IgG4-RD）患者慢性鼻-鼻窦炎（CRS）与全身症状之间的关系。
方法
选取 2013 年 3 月至 2016 年 7 月首都医科大学附属北京同仁医院经限制关联临床和组织病理学表现确诊的 IgG4-RD 患者为研究对象，随访 1 年。将患者分为两组：病例组为 IgG4-RD 患者伴临床和影像学证实的 CRS，对照组为 IgG4-RD 患者无临床和影像学证实的 CRS。比较两组患者的年龄、性别、临床表现、外周血嗜酸性粒细胞百分比、血沉（ESR）、C 反应蛋白、血清 IgE 和 IgG4 水平、组织病理学及治疗药物。
结果
共 46 例患者符合 IgG4-RD 诊断标准。共 30 例（65.2%）患者合并 CRS，年龄为 49.7±13.4 岁，男女比例为 2∶1。病例组患者的病程长于对照组（3.0 比 0.8，p=0.009）。眼部受累比例较高（86.7%比 60%，p<0.001），过敏性表现包括药物过敏、哮喘和过敏性皮肤更常见（56.5%比 20%，p=0.004），外周血嗜酸性粒细胞百分比较高（8.5%比 3.3%，p=0.018），对糖皮质激素更敏感（6.0 比 3.5，p=0.004）。
结论
IgG4-RD 患者的 CRS 与 IgG4 相关眼部病变密切相关，更易伴有外周血嗜酸性粒细胞百分比升高的过敏表现。伴有 CRS 的 IgG4-RD 患者的治疗效果优于不伴有 CRS 的 IgG4-RD 患者。
Zotero 插件