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IgG4 相关消化系统疾病:诊断与治疗。

IgG4-related digestive diseases: diagnosis and treatment.

机构信息

Graduate School, Heilongjiang University of Chinese Medicine, Harbin, China.

Department of Internal Medicine, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China.

出版信息

Front Immunol. 2023 Oct 5;14:1278332. doi: 10.3389/fimmu.2023.1278332. eCollection 2023.

Abstract

IgG4-related digestive diseases encompass a group of chronic inflammatory disorders characterized by autoimmune reactions and fibrosis affecting multiple digestive organs. These diseases are identified by elevated serum levels of IgG4 and the presence of IgG4-positive plasma cell infiltration in the affected sites, along with storiform fibrosis, obliterative phlebitis, and eosinophilic infiltration. Although extensive research has been conducted, a comprehensive understanding of these conditions remains elusive. Current clinical diagnosis often relies on the application of integrated diagnostic criteria for IgG4-related diseases, combined with specific organ involvement criteria. Distinguishing them from malignancies poses considerable challenges. Moreover, further investigations are required to elucidate the underlying pathogenic mechanisms and explore potential therapeutic interventions. This review provides a systematic classification of IgG4-related digestive diseases while discussing their diagnostic strategies, clinical presentations, and treatment modalities. The comprehensive insights shared herein aim to guide clinicians in their practice and contribute to the advancement of knowledge in this field.

摘要

IgG4 相关消化系统疾病包括一组慢性炎症性疾病,其特征为影响多个消化器官的自身免疫反应和纤维化。这些疾病通过血清 IgG4 水平升高以及受累部位 IgG4 阳性浆细胞浸润、席纹状纤维化、闭塞性静脉炎和嗜酸性粒细胞浸润来确定。尽管已经进行了广泛的研究,但对这些疾病的全面了解仍然难以捉摸。目前的临床诊断通常依赖于 IgG4 相关疾病的综合诊断标准,结合特定器官受累标准。将它们与恶性肿瘤区分开来具有相当大的挑战性。此外,还需要进一步研究来阐明潜在的发病机制并探索潜在的治疗干预措施。本综述提供了 IgG4 相关消化系统疾病的系统分类,同时讨论了它们的诊断策略、临床表现和治疗方式。本文提供的全面见解旨在为临床医生的实践提供指导,并为该领域的知识进步做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4431/10585276/5a46ca66956f/fimmu-14-1278332-g001.jpg

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