Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, and Department of Rheumatology and Immunology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, China.
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, and Department of Rheumatology and Immunology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Clin Exp Rheumatol. 2023 Sep;41(9):1808-1814. doi: 10.55563/clinexprheumatol/3l5o9u. Epub 2023 Feb 11.
This study aimed to elucidate different clinical profiles in IgG4-related disease (IgG4-RD) with and without allergy.
Four hundred and thirty-four patients diagnosed with IgG4-RD at Peking University People's Hospital were included. Clinical and treatment options-based relapse data were collected and compared between IgG4-RD patients with and without allergy.
Among these patients, 214 (49.3%) had allergic diseases. Most of the IgG4-RD patients with allergy had initial involved organs directly exposed to ambient air and their allergic symptoms occurred mostly before or at IgG4-RD disease onset. Compared with IgG4-RD patients without allergy, allergic patients had almost equal sex ratio, more organ involvement, earlier ages of disease onset and diagnosis, longer disease duration, higher incidence of dacryoadenitis, sialadenitis, lymphadenopathy, paranasal sinus and lung lesions. Higher serum IgG4, IgE and IgG4/IgG ratio, lower serum C3 complement 3 (C3) and C4, and higher incidence of eosinophilia were also found in IgG4-RD patients with allergy. Furthermore, allergy may increase relapse rate and shorten relapse-free survival time in IgG4-RD patients treated with glucocorticoids only, whereas combination therapy of glucocorticoids and immunosuppressants could improve treatment outcome.
Allergy leads to disparities in clinical profiles in IgG4-RD patients. Allergy could result in higher relapse rate and shorten relapse-free survival time in patients receiving glucocorticoids only.
本研究旨在阐明 IgG4 相关疾病（IgG4-RD）合并与不合并过敏的不同临床特征。
纳入北京大学人民医院确诊的 434 例 IgG4-RD 患者。收集并比较 IgG4-RD 患者合并与不合并过敏的临床及基于治疗方案的复发数据。
在这些患者中，214 例（49.3%）有过敏疾病。大多数合并过敏的 IgG4-RD 患者最初受累器官直接暴露于环境空气中，且过敏症状多发生于 IgG4-RD 发病前或同时。与不合并过敏的 IgG4-RD 患者相比，过敏患者的性别比几乎相等，受累器官更多，发病和诊断年龄更早，疾病持续时间更长，泪腺炎、涎腺炎、淋巴结病、副鼻窦和肺部病变的发生率更高。合并过敏的 IgG4-RD 患者的血清 IgG4、IgE 和 IgG4/IgG 比值更高，血清 C3 补体 3（C3）和 C4 更低，嗜酸性粒细胞增多症的发生率更高。此外，对于仅接受糖皮质激素治疗的 IgG4-RD 患者，过敏可能会增加复发率并缩短无复发生存时间，而糖皮质激素联合免疫抑制剂治疗可改善治疗结局。
过敏导致 IgG4-RD 患者的临床特征存在差异。过敏会导致仅接受糖皮质激素治疗的患者复发率更高，无复发生存时间更短。
