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Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan.

Okazaki K, Umehara H - Int J Rheumatol (2012)

Bottom Line: Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis.Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the "Research Program for Intractable Disease" of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as "IgG4-RD" and proposed the comprehensive diagnostic criteria (CDC) for IgG4-RD.Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP), compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease) and IgG4-related kidney disease.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, The Third Department of Internal Medicine, Kansai Medical University, Shinmachi, Hirakata, Osaka 573-1197, Japan.

ABSTRACT
Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the "Research Program for Intractable Disease" of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as "IgG4-RD" and proposed the comprehensive diagnostic criteria (CDC) for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP), compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease) and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity.

No MeSH data available.


Related in: MedlinePlus

Clinical findings of IgG4-related disease. Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs.
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fig1: Clinical findings of IgG4-related disease. Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs.

Mentions: Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs (Figure 1).


Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan.

Okazaki K, Umehara H - Int J Rheumatol (2012)

Clinical findings of IgG4-related disease. Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3368488&req=5

fig1: Clinical findings of IgG4-related disease. Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs.
Mentions: Physical examinations and imaging on US/CT/MRI can show the characteristic diffuse/localized swelling, masses, or thickness in single or multiple organs (Figure 1).

Bottom Line: Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis.Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the "Research Program for Intractable Disease" of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as "IgG4-RD" and proposed the comprehensive diagnostic criteria (CDC) for IgG4-RD.Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP), compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease) and IgG4-related kidney disease.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, The Third Department of Internal Medicine, Kansai Medical University, Shinmachi, Hirakata, Osaka 573-1197, Japan.

ABSTRACT
Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the "Research Program for Intractable Disease" of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as "IgG4-RD" and proposed the comprehensive diagnostic criteria (CDC) for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP), compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease) and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity.

No MeSH data available.


Related in: MedlinePlus