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2020年修订的IgG4相关性疾病综合诊断(RCD)标准。

The 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD.

作者信息

Umehara Hisanori, Okazaki Kazuichi, Kawa Shigeyuki, Takahashi Hiroki, Goto Hiroshi, Matsui Shoko, Ishizaka Nobukazu, Akamizu Takashi, Sato Yasuharu, Kawano Mitsuhiro

机构信息

Center for RA and Autoimmune Diseases, Nagahama City Hospital, Shiga, Japan.

Division of Gastroenterology and Hepatology, The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.

出版信息

Mod Rheumatol. 2021 May;31(3):529-533. doi: 10.1080/14397595.2020.1859710. Epub 2021 Jan 28.

Abstract

IgG4-related disease (IgG4-RD) is a fascinating clinical entity first reported in this century in Japan, and includes a wide variety of diseases, such as formerly named Mikulicz's disease (MD), autoimmune pancreatitis (AIP), interstitial nephritis, prostatitis and retroperitoneal fibrosis. The Japanese IgG4 team organized by the Ministry of Health, Labor and Welfare (MHLW) of Japan has published the first criteria, comprehensive diagnostic (CD) criteria for IgG-RD 2011. Thereafter, IgG4-RD has been accepted widely and many cases have been reported from all over the world. Several problems have arisen in clinical practice, however, including the difficulty obtaining biopsy samples, and the sensitivity and specificity in cut off level of serum IgG4 and impaired immunostaining of IgG4. Given these situations, the Japanese IgG4 team has updated the 2011 comprehensive diagnostic criteria for IgG4-RD and propose the 2020 revised comprehensive diagnostic (RCD) criteria for IgG4-RD, which consists of 3 domains; 1) Clinical and radiological features, 2) Serological diagnosis and 3) Pathological diagnosis. In addition, the new pathological diagnosis is composed by three sub-items including storiform fibrosis and obliterative phlebitis.

摘要

IgG4相关疾病(IgG4-RD)是本世纪在日本首次报道的一种引人关注的临床实体,包括多种疾病,如曾被称为米库利奇病(MD)、自身免疫性胰腺炎(AIP)、间质性肾炎、前列腺炎和腹膜后纤维化。由日本厚生劳动省(MHLW)组建的日本IgG4研究团队发布了首个IgG-RD综合诊断(CD)标准——2011版。此后,IgG4-RD被广泛认可,世界各地报道了许多病例。然而,临床实践中出现了一些问题,包括获取活检样本困难、血清IgG4临界值的敏感性和特异性以及IgG4免疫染色受损。鉴于这些情况,日本IgG4研究团队对2011版IgG4-RD综合诊断标准进行了更新,并提出了2020版IgG4-RD修订综合诊断(RCD)标准,该标准由三个领域组成:1)临床和放射学特征,2)血清学诊断,3)病理学诊断。此外,新的病理学诊断由包括席纹状纤维化和闭塞性静脉炎在内的三个子项目组成。

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