29例IgG4相关疾病临床特征分析

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29例IgG4相关疾病临床特征分析

临床医学 | 更新时间：2026-01-09

- 29例IgG4相关疾病临床特征分析
- Clinical characteristics of IgG4-related disease: analysis of 29 cases
- 第三军医大学学报 2021年43卷第20期页码：2255-2259
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院呼吸与危重症医学科
- 作者简介：
  
  [ 祝冰晶，E-mail：bingjing1017@163.com ZHU Bingjing, E-mail: bingjing1017@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202104111
  中图分类号： R392.11;R392.3;R593.04
- 收稿：2021-04-18，
  
  修回：2021-07-04，
  
  纸质出版：2021-10-30
- 稿件说明：
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郭海琴, 祝冰晶. 29例IgG4相关疾病临床特征分析[J]. 第三军医大学学报, 2021,43(20):2255-2259.

Haiqin GUO, Bingjing ZHU. Clinical characteristics of IgG4-related disease: analysis of 29 cases[J]. Journal of Third Military Medical University, 2021, 43(20): 2255-2259.
郭海琴, 祝冰晶. 29例IgG4相关疾病临床特征分析[J]. 第三军医大学学报, 2021,43(20):2255-2259. DOI： 10.16016/j.1000-5404.202104111.

Haiqin GUO, Bingjing ZHU. Clinical characteristics of IgG4-related disease: analysis of 29 cases[J]. Journal of Third Military Medical University, 2021, 43(20): 2255-2259. DOI： 10.16016/j.1000-5404.202104111.

摘要

目的

2

分析IgG4相关疾病临床特征，探讨血清IgG4升高对辅助诊断IgG4相关疾病的临床意义。

方法

2

收集2010年1月至2020年11月就诊于我院诊断IgG4相关疾病患者，对其临床表现、受累器官、实验室检查、组织病理、治疗情况等进行回顾性分析。

结果

2

① 29例临床诊断IgG4相关疾病，其中男∶女=1.64∶1；②颌下腺肿大、多发淋巴结肿大是IgG4相关疾病最常见的症状表现，肺、肝、泪腺/眼睑、胸膜、心包膜、胰腺、皮肤、胆道、腮腺、肾脏、乳腺等多器官均可受累；③29例患者血清IgG4介于57.3~2 000.0 mg/dL，约93.1% IgG4-RD血清IgG4升高，IgG升高比例为53.8%；④29例患者中10例予糖皮质激素和/或免疫抑制剂治疗后病灶缩小，IgG4降低，预后得到改善。

结论

2

IgG4-RD好发于中老年男性，可累及多器官，首发症状及临床表现多样；血清IgG4是IgG4-RD诊断的重要指标，但需排除血管炎、肿瘤性疾病、感染性疾病、Castleman病及其他结缔组织病。

Abstract

Objective

2

To analyze the clinical characteristics of IgG4-related disease (IgG4-RD) and to explore the clinical significance of serum IgG4 elevation in auxiliary diagnosis of IgG4-RD.

Methods

2

Clinical data of the patients diagnosed with IgG4-RD in our hospital from January 2010 to November 2020 were collected

and their clinical manifestations

involved organs

results of laboratory examinations

histopathology and treatment were retrospectively analyzed.

Results

2

① Among the 29 cases eventually enrolled

there were 18 males and 11 females

with a ratio of male to female of 1.64; ② Submandibular gland enlargement and multiple lymph node adenopathy were the most common symptoms. And multiple organs such as the lung

liver

lacrimal gland/eyelid

pleura

pericardium

pancreas

skin

biliary tract

parotid gland

kidney and breast were also afflicted; ③ Their serum IgG4 level ranged from 57.3 to 2 000.0 mg/dL. About 93.1% of them had elevated IgG4 level

and 53.8% got IgG elevation; ④ Ten cases were treated with glucocorticoid and/or immunosuppressant

and they got shrunk lesions

dropped IgG4 level and good prognosis.

Conclusion

2

IgG4-RD is more common in middle-aged and elderly men

involving multiple organs

with various initial symptoms and clinical manifestations. Serum IgG4 is an important indicator for the diagnosis of IgG4-RD

but vasculitis

tumor diseases

infectious diseases

Castleman disease and other connective tissue diseases should be carefully excluded.

关键词

Keywords

references

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MAEH ARA T, MORIYAMA M, NAKASHIMA H, et al . Interleukin-21 contributes to germinal centre formation and immunoglobulin G4 production in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz's disease[J ] . Ann Rheum Dis, 2012, 71(12): 2011-2019. DOI: 10.1136/annrheumdis-2012-201477.

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