The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2020 Aug 1;59(15):1905-1911. doi: 10.2169/internalmedicine.4127-19. Epub 2020 Apr 30.
We herein report five patients with nasal mucosa and sinus involvement who were diagnosed with immunoglobulin G4-related disease (IgG4-RD). In all cases, the lacrimal, parotid, and submandibular glands were swollen; biopsies of these glands were risky, so the labium and nasal mucosa were instead targeted. All patients tested positive through these biopsies, suggesting alternative sites for confirming IgG4-RD. These five patients had first been diagnosed and unsuccessfully treated for allergic rhinitis or chronic sinusitis. After the IgG4-RD diagnosis, they were administered corticosteroid therapy, which drastically improved the nasal mucosa and sinus involvement. When refractory allergic rhinitis or sinusitis is detected, IgG4-RD should be considered.
我们在此报告 5 例伴有鼻黏膜和鼻窦受累的 IgG4 相关疾病(IgG4-RD)患者。所有患者均有泪腺、腮腺和颌下腺肿胀;这些腺体的活检存在风险,因此选择唇和鼻黏膜作为活检部位。所有患者的活检均呈阳性,提示存在可替代的 IgG4-RD 确诊部位。这 5 例患者最初被诊断为变应性鼻炎或慢性鼻窦炎,并接受了治疗,但效果不佳。在 IgG4-RD 诊断后,他们接受了皮质类固醇治疗,这极大地改善了鼻黏膜和鼻窦受累情况。当检测到难治性变应性鼻炎或鼻窦炎时,应考虑 IgG4-RD。