IgG4-associated sialadenitis.

TitleIgG4-associated sialadenitis.
Publication TypeJournal Article
Year of Publication2011
AuthorsGeyer JT, Deshpande V
JournalCurr Opin Rheumatol
Volume23
Issue1
Pagination95-101
Date Published2011 Jan
ISSN1531-6963
KeywordsAutoimmune Diseases, Diagnosis, Differential, Female, Humans, Immunoglobulin G, Lymphoma, Non-Hodgkin, Male, Mikulicz' Disease, Orbital Pseudotumor, Pancreatitis, Plasma Cells, Salivary Gland Neoplasms, Sialadenitis, Sjogren's Syndrome
Abstract

PURPOSE OF REVIEW: An enlarged salivary gland or lacrimal gland raises a wide differential diagnosis that includes both benign inflammatory conditions and malignant disorders. This review aims to address the numerous controversies that have arisen regarding inflammatory diseases of the salivary gland over the past two centuries and more specifically address the relevance of IgG4 in this setting.

RECENT FINDINGS: A significant percentage of cases previously classified as Mikulicz disease, Küttner tumor, and orbital pseudotumor (idiopathic orbital inflammation) show elevated numbers of IgG4-positive plasma cells, and some of these cases also show elevated levels of serum IgG4. These data support the evolving concept of IgG4-associated sialadenitis/dacroadenitis. The disease presents with enlargement of one of more salivary gland(s) and/or lacrimal gland(s). Histologically this disease is characterized by a dense polyclonal lymphoplasmacytic infiltrate, and is frequently associated with germinal centers, fibrosis and obliterative phlebitis. IgG4-bearing plasma cells are virtually always present, as is an elevated ratio of IgG4 to IgG containing plasma cells.

SUMMARY: IgG4-related sialadenitis belongs to the IgG4-related systemic disease spectrum and shows a swift response to immunosuppression.

DOI10.1097/BOR.0b013e3283413011
Alternate JournalCurr Opin Rheumatol
PubMed ID21124091
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