头颈部免疫球蛋白G4相关疾病：系统评价
Head and neck immunoglobulin G4 related disease: systematic review.
作者信息
Tirelli G, Gardenal N, Gatto A, Quatela E, Del Piero G C
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, University of Trieste, Cattinara Hospital, Italy.
出版信息
J Laryngol Otol. 2018 Dec;132(12):1046-1050. doi: 10.1017/S0022215118002153. Epub 2018 Dec 18.
BACKGROUND
Immunoglobulin G4 related disease is a recently described systemic syndrome. The head and neck region is the second most common site for presentation after the pancreas.
METHODS
PubMed and the Cochrane Library were searched from 1995 to July 2017 for all the studies on immunoglobulin G4 related disease diagnosed in the head and neck compartment. Patient-specific data were extracted and basic statistical analysis was performed.
RESULTS
Ninety-one patients were identified. Treatment was specified in 76 patients. Twenty patients received surgical treatment, eight of them in association with medical therapy. Fifty-six patients received medical treatment. The disease recurred in 25 per cent of patients treated with surgical treatment alone, in 3.6 per cent of patients treated with medical treatment alone and in 12.5 per cent of patients treated with both. All medical treatment protocols contained high-dose corticosteroids.
CONCLUSION
Early and correct diagnosis can avoid unnecessary surgical treatment, and glucocorticoid therapy can improve the long-term prognosis.
背景
免疫球蛋白G4相关疾病是一种最近才被描述的全身性综合征。头颈部是继胰腺之后第二常见的发病部位。
方法
检索1995年至2017年7月期间PubMed和考克兰图书馆中所有关于头颈部确诊的免疫球蛋白G4相关疾病的研究。提取患者的具体数据并进行基本统计分析。
结果
共识别出91例患者。76例患者有明确的治疗方法。20例患者接受了手术治疗，其中8例同时接受了药物治疗。56例患者接受了药物治疗。单纯接受手术治疗的患者中25%疾病复发，单纯接受药物治疗的患者中3.6%疾病复发，同时接受手术和药物治疗的患者中12.5%疾病复发。所有药物治疗方案均包含高剂量糖皮质激素。
结论
早期正确诊断可避免不必要的手术治疗，糖皮质激素治疗可改善长期预后。
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