SIGNIFICANCE OF IgG4 IN IDIOPATHIC RETROPERITONEAL FIBROSIS
| العنوان: | SIGNIFICANCE OF IgG4 IN IDIOPATHIC RETROPERITONEAL FIBROSIS |
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| المؤلفون: | Masaaki, Sanda, Naoto, Kamiya, Yuka, Sugizaki, Takamichi, Mori, Masayasu, Sugiyama, Seiji, Kato, Ryo, Oka, Takanobu, Utsumi, Takumi, Endo, Masashi, Yano, Nobuyuki, Hiruta, Hiroyoshi, Suzuki |
| المصدر: | The Japanese Journal of Urology. 112:192-198 |
| بيانات النشر: | Japanese Urological Association, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Urology |
| الوصف: | (Objective)Retroperitoneal fibrosis is largely divided into the idiopathic and secondary types. Some idiopathic cases include IgG4-related diseases, which are often similar to malignant diseases, such as lymphoma and sarcoma. The diagnostic criteria for IgG4-related disease are used and pathologic examination is necessary for a definitive diagnosis of IgG4-related retroperitoneal fibrosis. The first choice of treatment for IgG4-related retroperitoneal fibrosis is steroid administration, but no consensus has been established regarding its dose and tapering schedule. We investigated the significance of IgG4 in diagnosis and treatment of idiopathic retroperitoneal fibrosis. (Patients and methods)We examined 14 cases diagnosed as idiopathic retroperitoneal fibrosis between April 2013 and March 2019. Serum IgG4 was measured at the time of diagnosis in 13 cases, and changes over time in serum IgG4 before and after the induction of steroid therapy were measured in 6 cases. Computed tomography-guided biopsy was performed on 4 cases. (Results)Of all cases, 1 patient was diagnosed as IgG4-related retroperitoneal fibrosis and 5 patients were classified as possible group. Ten patients were administered steroid therapy. Percutaneous nephrostomy tube was placed in 3 patients and was removed in 2 of these patients after steroid therapy. The serum high levels of IgG4 were confirmed in all 4 patients who were classified into the possible group and who were treated with steroids. (Conclusion)Although histologic examination is necessary for the diagnosis of retroperitoneal fibrosis, tissue collection by open or laparoscopic surgery is highly invasive. CT-guided biopsy may be useful in high-risk cases, such as elderly patients on anticoagulation. After excluding other diseases in high-risk cases, response to empiric steroid therapy may be diagnostic. In the possible group, changes in serum IgG4 levels may reflect the disease condition and might be useful in determining the maintenance dose of steroids. |
| تدمد: | 1884-7110 0021-5287 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::78f735fa70f44cb7c64f769ea5d15f40 https://doi.org/10.5980/jpnjurol.112.192 |
| رقم الأكسشن: | edsair.doi.dedup.....78f735fa70f44cb7c64f769ea5d15f40 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18847110 00215287 |
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