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IgG4 硬化性疾病的食管:基于病例的综述。

IgG4 sclerosing disease of the esophagus: a case-based review.

机构信息

Internal Medicine Residency, Hennepin Healthcare, Minneapolis, Minnesota, USA.

Rheumatology Fellowship Program, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

Rheumatol Int. 2020 Oct;40(10):1733-1737. doi: 10.1007/s00296-020-04594-5. Epub 2020 May 2.

Abstract

IgG4-related disease (IgG4-RD) is an inflammatory and fibrosing disease which causes tumor-like swelling of organs and commonly mimics symptoms of malignancy. It has been increasing in prevalence in the last decade, but esophageal involvement remains rare. IgG4-RD was first known to involve certain organs, such as the pancreas. It has, since, been described as a systemic disease process. IgG4-RD should be considered in patients presenting with dysphagia. Initiation of appropriate treatment with corticosteroids can avoid unnecessary procedures and improve outcomes. The aim of this review is to discuss 17 cases of IgG4-RD of the esophagus. Literature review was conducted using NCBI database (PMC and PubMed filters) using the keywords "IgG4 disease," "sclerosing," "esophagus" and "gastrointestinal." The search was narrowed to include cases describing IgG4 disease of the esophagus using the same filters. Literature review identified 16 documented cases of IgG4-RD involving the esophagus. Upon literature review, it remains clear that it is extremely rare for IgG4-RD to affect the esophagus. Sixteen cases have been reported. We present a 17th case and discuss the implications of IgG4-RD. It is important to keep a broad differential diagnosis that includes IgG4-RD for patients presenting with dysphagia, especially when symptoms are refractory.

摘要

IgG4 相关疾病(IgG4-RD)是一种炎症性和纤维化疾病,可导致器官类似肿瘤的肿胀,并常模拟恶性肿瘤的症状。在过去十年中,其患病率一直在增加,但食管受累仍然很少见。IgG4-RD 最初被认为涉及某些器官,如胰腺。此后,它被描述为一种全身性疾病过程。当出现吞咽困难时,应考虑 IgG4-RD。用皮质类固醇进行适当的治疗可以避免不必要的程序并改善预后。本综述的目的是讨论 17 例 IgG4-RD 食管病例。使用 NCBI 数据库(PMC 和 PubMed 过滤器),使用关键词“IgG4 疾病”、“硬化”、“食管”和“胃肠道”进行文献回顾。搜索范围缩小到使用相同过滤器描述食管 IgG4 疾病的病例。文献回顾确定了 16 例涉及食管的 IgG4-RD 病例。通过文献回顾,很明显,IgG4-RD 极罕见于影响食管。已经报告了 16 例。我们提出了第 17 例病例,并讨论了 IgG4-RD 的意义。对于出现吞咽困难的患者,尤其是症状难治的患者,保持包括 IgG4-RD 在内的广泛鉴别诊断非常重要。

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