Department of Rheumatology and Immunology, Peking University People's Hospital, 11, Xizhimen South Street, Beijing, 100044, China.
Department of Rheumatology and Immunology, People's Hospital of Hebei Province, Shijiazhuang, China.
Sci Rep. 2022 Jul 14;12(1):12039. doi: 10.1038/s41598-022-15398-x.
In clinical practice, we found that IgG4-related disease (IgG4-RD) patients complicated with allergic rhinitis (AR)/chronic rhinosinusitis (CRS) seemed to have unique characteristics different from patients with IgG4-RD alone. In this study, demographic, clinical and laboratory characteristics of IgG4-RD patients complicated with AR/CRS were investigated. We retrospectively analyzed 756 IgG4-RD patients who were recruited in four medical centers from 2009 to 2021. We divided 756 IgG4-RD patients into 2 groups: the case group included IgG4-RD patients complicated with AR/CRS, and the control group included IgG4-RD patients without AR/CRS. 411 patients were complicated with AR/CRS among 756 IgG4-RD patients. Multiple organs involvement (≥ 3, p < 0.0001, OR 3.585 (95% CI 2.655-4.839)) and other types of allergic disease (p < 0.0001, OR 2.007 (95% CI 1.490-2.693)) were more common in the case group. Patients in the case group had a higher level of serum IgG4 (650 mg/dL vs 385 mg/dL, p < 0.0001), IgE (347 mg/dL vs 98 mg/dL, p < 0.0001) and ESR (14 mm/h vs 12 mm/h, p < 0.05). High IgE level (p < 0.01, OR 1.003 (95% CI 1.001-1.005)) and other types of allergic disease (p < 0.05, OR 3.196 (95% CI 1.146-8.908)) were risk factors for patients in the case group, in which most patients had nasal manifestations before the diagnosis of IgG4-RD. The median time interval from nasal symptoms appearance to IgG4-RD diagnosis was - 120 and - 90 months for patients complicated with AR and CRS, respectively. IgG4-RD patients are often complicated with AR/CRS and have distinct characteristics, which appear to be a subgroup of IgG4-RD. The data suggests a pathogenic association of IgG4-RD and AR/CRS.
在临床实践中,我们发现 IgG4 相关疾病(IgG4-RD)合并过敏性鼻炎(AR)/慢性鼻-鼻窦炎(CRS)的患者似乎具有与单纯 IgG4-RD 患者不同的独特特征。在这项研究中,我们调查了 IgG4-RD 合并 AR/CRS 患者的人口统计学、临床和实验室特征。我们回顾性分析了 2009 年至 2021 年在四个医疗中心招募的 756 例 IgG4-RD 患者。我们将 756 例 IgG4-RD 患者分为 2 组:病例组包括 IgG4-RD 合并 AR/CRS 的患者,对照组包括 IgG4-RD 无 AR/CRS 的患者。在 756 例 IgG4-RD 患者中,有 411 例合并 AR/CRS。病例组中,多器官受累(≥3 个,p<0.0001,OR 3.585(95%CI 2.655-4.839))和其他类型的过敏性疾病(p<0.0001,OR 2.007(95%CI 1.490-2.693))更为常见。病例组患者的血清 IgG4 水平更高(650mg/dL 比 385mg/dL,p<0.0001),IgE 水平更高(347mg/dL 比 98mg/dL,p<0.0001),ESR 水平更高(14mm/h 比 12mm/h,p<0.05)。高 IgE 水平(p<0.01,OR 1.003(95%CI 1.001-1.005))和其他类型的过敏性疾病(p<0.05,OR 3.196(95%CI 1.146-8.908))是病例组患者的危险因素,其中大多数患者在 IgG4-RD 诊断前就已经有鼻部表现。从鼻部症状出现到 IgG4-RD 诊断的中位时间间隔分别为 AR 患者为-120 个月和 CRS 患者为-90 个月。IgG4-RD 患者常合并 AR/CRS,且具有明显特征,似乎是 IgG4-RD 的一个亚组。这些数据提示 IgG4-RD 与 AR/CRS 之间存在发病关联。