The clinical characteristics of patients with IgG4-related disease with infiltration of the labial salivary gland by IgG4-positive cells. Issue 6 (November 2014)

• Record Type: Journal Article
• Authors: Abe, Ayumi; Takano, Kenichi; Seki, Nobuhiko; Jitsukawa, Sumito; Yamamoto, Motohisa; Takahashi, Hiroki; Himi, Tetsuo
• Is Part Of: Modern rheumatology. Volume 24:Issue 6(2014)
• Page Start: 949
• Page End: 952
• Publication Date: 2014-11
• Subjects: Rheumatology -- Periodicals; 616.723005
• DOI: 10.3109/14397595.2014.891964
• Languages: English
• ISSNs: 1439-7595

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objectives.</italic> Mikulicz's disease (MD) is an immunoglobulin (Ig) G4-related disease with systemic symptoms. Submandibular gland (SMG) biopsy is recommended for patients with possible IgG4-related MD for accurate differential diagnosis; however, it is difficult for certain patients to undergo this procedure. In contrast, labial salivary gland (LSG) biopsy is more convenient. Here we present an analysis of patients with IgG4-related MD whose LSG specimens were infiltrated with abundant IgG4-positive plasma cells.</p> <p> <italic>Methods.</italic> Sixteen patients diagnosed with IgG4-related MD underwent simultaneous SMG and LSG biopsies. We evaluated patients' serological and <sup>18</sup>F-fluoro-2-deoxyglucose-positron emission tomography/computed tomography (<sup>18</sup>F-FDG-PET/CT) and grouped them as LSG+ (LSG specimens with > 40% IgG4-positive plasma cells/IgG-positive plasma cells, 11 patients) or LSG− (LSG specimens with < 40% IgG4-positive plasma cells/IgG-positive plasma cells, 6 patients).</p> <p> <italic>Results.</italic> There were not significant differences in serum IgG and IgG4 levels between the two groups; however, serum concentrations of soluble interleuikin-2 receptor (sIL-2R) were significantly higher in the LSG+ group. All patients with increased <sup>18</sup>F-FDG uptake in their parotid glands were a part of the LSG+ group.</p> <p> <italic>Conclusions.</italic> When a SMG biopsy is not possible, the serum concentration of sIL-2R and <sup>18</sup>F-FDG-PET/CT findings may predict whether LSG biopsy will facilitate the diagnosis of IgG4-related MD.</p> </abstract>