Deconstructing IgG4-related disease involvement of midline structures: Comparison to common mimickers
| Autor: | Lanzillotta M, Campochiaro C, Trimarchi M, Arrigoni G, Gerevini S, Milani R, Bozzolo E, Biafora M, Venturini E, Cicalese MP, Stone JH, Sabbadini MG, Della-Torre E, DELLA TORRE , EMANUEL |
|---|---|
| Přispěvatelé: | Lanzillotta, M, Campochiaro, C, Trimarchi, M, Arrigoni, G, Gerevini, S, Milani, R, Bozzolo, E, Biafora, M, Venturini, E, Cicalese, Mp, Stone, Jh, Sabbadini, Mg, Della-Torre, E, DELLA TORRE, Emanuel |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Adolescent Plasma Cells Immunologic Tests Tertiary care Serology Young Adult 03 medical and health sciences 0302 clinical medicine Rheumatology parasitic diseases medicine Humans 030223 otorhinolaryngology Aged 030203 arthritis & rheumatology Nasal endoscopy Nasal Septal Perforation business.industry fungi Granulomatosis with Polyangiitis Middle Aged Flow Cytometry medicine.disease Immunoglobulin G Female IgG4-related disease business Granulomatosis with polyangiitis Immunostaining |
| Zdroj: | Modern Rheumatology. 27:638-645 |
| ISSN: | 1439-7609 1439-7595 |
| DOI: | 10.1080/14397595.2016.1227026 |
| Popis: | Objective: A series of destructive and tumefactive lesions of the midline structures have been recently added to the spectrum of IgG4-related disease (IgG4-RD). We examined the clinical, serological, endoscopic, radiological, and histological features that might be of utility in distinguishing IgG4-RD from other forms of inflammatory conditions with the potential to involve the sinonasal area and the oral cavity. Methods: We studied 11 consecutive patients with erosive and/or tumefactive lesions of the midline structures referred to our tertiary care center. All patients underwent serum IgG4 measurement, flow cytometry for circulating plasmablast counts, nasal endoscopy, radiological studies, and histological evaluation of tissue specimens. The histological studies included immunostaining studies to assess the number of IgG4 + plasma cells/HPF for calculation of the IgG4+/IgG + plasma cell ratio. Results: Five patients with granulomatosis with polyangiitis (GPA), three with cocaine-induced midline destructive lesions (CIMDL), and three with IgG4-RD were studied. We found no clinical, endoscopic, or radiological findings specific for IgG4-RD. Increased serum IgG4 and plasmablasts levels were not specific for IgG4-RD. Rather, all 11 patients had elevated blood plasmablast concentrations, and several patients with GPA and CIMDL had elevated serum IgG4 levels. Storiform fibrosis and an IgG4+/IgG + plasma cell ratio >20% on histological examination, however, were observed only in patients with IgG4-RD. Conclusions: Histological examination of bioptic samples from the sinonasal area and oral cavity represents the mainstay for the diagnosis of IgG4-RD involvement of the midline structures |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|