S imunoglobulinem IgG4 asociované onemocnění

Title in English IgG4 releated disease
Authors

ADAM Zdeněk KREJČÍ Marta CHOVANCOVÁ Zita ŘEHÁK Z. KOUKALOVÁ Renata ŠTORK Martin ČERMÁK Aleš ŘÍHOVÁ Lucie POUR Luděk

Year of publication 2018
Type Article in Periodical
Magazine / Source Transfúze a hematologie dnes
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.prolekare.cz/casopisy/transfuze-hematologie-dnes/2018-2-6/s-imunoglobulinem-igg4-asociovane-onemocneni-105250
Keywords IgG4 releated disease; IgG4 subclass of immuniglobuline; corticosteroids; rituximab
Description Ig-G4 related disease is a heterogeneous disorder with multi-organ involvement recognised as a separate entity at the start of this century only. Almost all organs can be involved by this disease, but mostly is manifested in gastrointestinal trakt and pankreas. In some patients it can cause retroperitoneal fibrosis and in some patients may be present as lymfadenopathy. Diagnosis involves establishing high circulating levels of IgG4 > 135 mg/dL, increased serum IgG4 to IgG ratio of > 8%, immunohistochemistry showing dense lymphoplasmacellular inflammatory infiltrate consisting of IgG4-positive plasma cells with storiform fibrosis and obliterative phlebitis, and increased IgG4 positive plasma cell. Glucocorticoids are the primary form of therapy. Rituximab is the second line of therapy in case of no responce to kortikosteroids or intolerance of corticosteroids.

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