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Clinicopathological characteristics of immunoglobulin G4-related sialadenitis.
Arthritis Res Ther 2015; 17:186AR

Abstract

INTRODUCTION

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition. Forty-two cases with immunoglobulin G4-related sialadenitis (IgG4-RS) confirmed by histopathological and immunohistochemical assessment were studied to clarify the clinicopathologic characteristics of the salivary glands involved in IgG4-RS, especially the relationship between the histopathologic features and function of salivary glands or serum levels of IgG4.

METHODS

Clinical, serologic, imaging and histopathological data of these cases were analyzed. CT volumes of submandibular, parotid, and lacrimal glands were calculated. The saliva flow rate was measured. Scintigraphy with 99mTc-pertechnetate was undertaken in 31 cases, and the concentration index (CI) and secretion index (SI) was calculated. Relationships between fibrosis severity and salivary gland function or serum IgG4 levels were analyzed.

RESULTS

The first symptom was swelling of bilateral submandibular or lacrimal glands. Physical examination showed multiple bilateral major salivary glands (including sublingual and accessory parotid glands) and lacrimal glands were enlarged in IgG4 RS. Multiple enlarged cervical lymph nodes were noted in 30 patients. Saliva flow at rest was lower than normal in 34 cases; stimulated saliva flow was lower than normal in 15 cases. Secretory function was reduced more severely in the submandibular glands than in the parotid glands. Serum levels of IgG4 were elevated in 95.2% of cases and 78.6% patients had increased IgE levels. Serum IgG4 level was higher and saliva secretion lower as glandular fibrosis increased.

CONCLUSIONS

Prominent changes in the morphology, histology, immunohistochemistry and secretion of the major salivary glands of IgG4-RS patients were accompanied by involvement of the lacrimal glands and cervical lymph nodes. Elevated IgE, allergic history, eosinophil infiltration suggest allergic reactions as a potential pathogenesis of IgG4-RS. Severity of glandular fibrosis correlated with salivary function and serum levels of IgG4.

Authors+Show Affiliations

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. liweibdkq@163.com.Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, 100081, China. 1554326447@qq.com.Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing, 100081, China. sunzhipeng@bjmu.edu.cn.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. czg4209@126.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. litongtong67@126.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. zhlie_doctor@sina.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. zk1938@aliyun.com.Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, 100081, China. honghua68@hotmail.com.Department of Nuclear Medicine, Affiliated Beijing Tong Ren Hospital Capital University of Medical Science, Beijing, 100730, China. leemei@trhos.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. dearhongxia@sina.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. jiazhengsu@163.com.Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing, 100081, China. zhangzy-bj@vip.sina.com.Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China. 57495011@99.com.Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China. hejing1105@gmail.com.Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China. liqq@bjmu.edu.cn.Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, 100081, China. gaoyan0988@163.com.Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, 100081, China. gyyu@263.net.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26194097

Citation

Li, Wei, et al. "Clinicopathological Characteristics of Immunoglobulin G4-related Sialadenitis." Arthritis Research & Therapy, vol. 17, 2015, p. 186.
Li W, Chen Y, Sun ZP, et al. Clinicopathological characteristics of immunoglobulin G4-related sialadenitis. Arthritis Res Ther. 2015;17:186.
Li, W., Chen, Y., Sun, Z. P., Cai, Z. G., Li, T. T., Zhang, L., ... Yu, G. Y. (2015). Clinicopathological characteristics of immunoglobulin G4-related sialadenitis. Arthritis Research & Therapy, 17, p. 186. doi:10.1186/s13075-015-0698-y.
Li W, et al. Clinicopathological Characteristics of Immunoglobulin G4-related Sialadenitis. Arthritis Res Ther. 2015 Jul 21;17:186. PubMed PMID: 26194097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinicopathological characteristics of immunoglobulin G4-related sialadenitis. AU - Li,Wei, AU - Chen,Yan, AU - Sun,Zhi-Peng, AU - Cai,Zhi-Gang, AU - Li,Tong-Tong, AU - Zhang,Lei, AU - Huang,Min-Xian, AU - Hua,Hong, AU - Li,Mei, AU - Hong,Xia, AU - Su,Jia-Zeng, AU - Zhang,Zhu-Yan, AU - Liu,Yan-Ying, AU - He,Jing, AU - Li,Zhan-Guo, AU - Gao,Yan, AU - Yu,Guang-Yan, Y1 - 2015/07/21/ PY - 2015/03/02/received PY - 2015/06/25/accepted PY - 2015/7/22/entrez PY - 2015/7/22/pubmed PY - 2016/4/9/medline SP - 186 EP - 186 JF - Arthritis research & therapy JO - Arthritis Res. Ther. VL - 17 N2 - INTRODUCTION: Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized fibro-inflammatory condition. Forty-two cases with immunoglobulin G4-related sialadenitis (IgG4-RS) confirmed by histopathological and immunohistochemical assessment were studied to clarify the clinicopathologic characteristics of the salivary glands involved in IgG4-RS, especially the relationship between the histopathologic features and function of salivary glands or serum levels of IgG4. METHODS: Clinical, serologic, imaging and histopathological data of these cases were analyzed. CT volumes of submandibular, parotid, and lacrimal glands were calculated. The saliva flow rate was measured. Scintigraphy with 99mTc-pertechnetate was undertaken in 31 cases, and the concentration index (CI) and secretion index (SI) was calculated. Relationships between fibrosis severity and salivary gland function or serum IgG4 levels were analyzed. RESULTS: The first symptom was swelling of bilateral submandibular or lacrimal glands. Physical examination showed multiple bilateral major salivary glands (including sublingual and accessory parotid glands) and lacrimal glands were enlarged in IgG4 RS. Multiple enlarged cervical lymph nodes were noted in 30 patients. Saliva flow at rest was lower than normal in 34 cases; stimulated saliva flow was lower than normal in 15 cases. Secretory function was reduced more severely in the submandibular glands than in the parotid glands. Serum levels of IgG4 were elevated in 95.2% of cases and 78.6% patients had increased IgE levels. Serum IgG4 level was higher and saliva secretion lower as glandular fibrosis increased. CONCLUSIONS: Prominent changes in the morphology, histology, immunohistochemistry and secretion of the major salivary glands of IgG4-RS patients were accompanied by involvement of the lacrimal glands and cervical lymph nodes. Elevated IgE, allergic history, eosinophil infiltration suggest allergic reactions as a potential pathogenesis of IgG4-RS. Severity of glandular fibrosis correlated with salivary function and serum levels of IgG4. SN - 1478-6362 UR - https://www.unboundmedicine.com/medline/citation/26194097/Clinicopathological_characteristics_of_immunoglobulin_G4_related_sialadenitis_ L2 - https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-015-0698-y DB - PRIME DP - Unbound Medicine ER -