A novel concept of Mikulicz's disease as IgG4-related disease

被引:100
作者
Himi, Tetsuo [1 ]
Takano, Kenichi [1 ]
Yamamoto, Motohisa [2 ]
Naishiro, Yasuyoshi [2 ]
Takahashi, Hiroki [2 ]
机构
[1] Sapporo Med Univ, Dept Otolaryngol, Sch Med, Sapporo, Hokkaido, Japan
[2] Sapporo Med Univ, Dept Internal Med 1, Sch Med, Sapporo, Hokkaido, Japan
关键词
Mikulicz's disease; Kuttner's tumor; Sjogren's syndrome; IgG4-related disease; Immunoglobulin G4; CHRONIC SCLEROSING SIALADENITIS; SERUM IGG SUBCLASSES; RETROPERITONEAL FIBROSIS; AUTOIMMUNE PANCREATITIS; SUBMANDIBULAR-GLAND; SJOGRENS-SYNDROME; CHOLANGITIS; INFILTRATION; SIMILARITIES; SPECTRUM;
D O I
10.1016/j.anl.2011.01.023
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Since Morgan's report in 1953, Mikulicz's disease (MD) has been considered part of primary Sjogren's syndrome (SS). However, MD has a unique presentation, including persistent swelling of the lacrimal and salivary glands, and is characterized by good responsiveness to glucocorticoids, leading to recovery of gland function. Recently, it has been revealed that MD patients show elevated serum immunoglobulin G4 (IgG4) levels and prominent infiltration of IgG4-positive plasmacytes. The complications of MD include autoimmune pancreatitis, retroperitoneal fibrosis, tubulointerstitial nephritis, autoimmune hypophysitis, and Riedel's thyroiditis, all of which show IgG4 involvement in their pathogenesis. Thus, MD is a systemic "IgG4-related disease." In addition, recent analyses have revealed that Kuttner's tumor (KT), a chronic sclerosing sialadenitis that presents with asymmetrical firm swelling of the submandibular glands, is also associated with prominent infiltration of IgG4-positive plasmacytes. MD and KT differ from SS and are thought to be singular systemic IgG4-related plasmacytic diseases. Here we discuss the results of recent studies and provide an overview of MD as an IgG4-related disease. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:9 / 17
页数:9
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