Abstract
Lymphadenopathy is frequently observed in patients with immunoglobulin G4-related disease (IgG4-RD) and sometimes appears as the first manifestation of the disease. The diagnosis of IgG4-related lymphadenopathy is complicated owing to a great histological diversity, with at least 5 histological subtypes. Indeed, lymph node biopsy may be performed under the suspicion that the lymphadenopathy is a malignant lymphoma or other lymphoproliferative disorder. The diagnosis of IgG4-RD is characterized by both elevated serum IgG4 (135mg/dL) and histopathological features, including a dense lymphoplasmacytic infiltrate rich in IgG4 + plasma cells (IgG4 +/IgG + plasma cell ratio 40%). However, patients with hyper-interleukin (IL-) 6 syndromes such as multicentric Castlemans disease, rheumatoid arthritis, and other immune-mediated conditions frequently show lymph node involvement and often fulfill the diagnostic criteria for IgG4-RD. Owing to these factors, IgG4-RD cannot be differentiated from hyper-IL-6 syndromes on the basis of histological findings alone. Laboratory analyses are crucial to differentiate between the 2 diseases. Hyper-IL-6 syndromes are characterized by elevated serum levels of IgG, IgA, IgM, and C-reactive protein (CRP); thrombocytosis; anemia; hypoalbuminemia; hypocholesterolemia. In contrast, IgG4-RD does not share any of these characteristics. Therefore, the diagnosis of IgG4-RD requires not only pathological findings but also clinical and laboratory analyses.
| Original language | English |
|---|---|
| Article number | 572539 |
| Journal | International Journal of Rheumatology |
| Volume | 2012 |
| DOIs | |
| Publication status | Published - 2012 |
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ASJC Scopus subject areas
- Rheumatology
- Immunology
Cite this
IgG4-related lymphadenopathy. / Sato, Yasuharu; Yoshino, Tadashi.
In: International Journal of Rheumatology, Vol. 2012, 572539, 2012.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - IgG4-related lymphadenopathy
AU - Sato, Yasuharu
AU - Yoshino, Tadashi
PY - 2012
Y1 - 2012
N2 - Lymphadenopathy is frequently observed in patients with immunoglobulin G4-related disease (IgG4-RD) and sometimes appears as the first manifestation of the disease. The diagnosis of IgG4-related lymphadenopathy is complicated owing to a great histological diversity, with at least 5 histological subtypes. Indeed, lymph node biopsy may be performed under the suspicion that the lymphadenopathy is a malignant lymphoma or other lymphoproliferative disorder. The diagnosis of IgG4-RD is characterized by both elevated serum IgG4 (135mg/dL) and histopathological features, including a dense lymphoplasmacytic infiltrate rich in IgG4 + plasma cells (IgG4 +/IgG + plasma cell ratio 40%). However, patients with hyper-interleukin (IL-) 6 syndromes such as multicentric Castlemans disease, rheumatoid arthritis, and other immune-mediated conditions frequently show lymph node involvement and often fulfill the diagnostic criteria for IgG4-RD. Owing to these factors, IgG4-RD cannot be differentiated from hyper-IL-6 syndromes on the basis of histological findings alone. Laboratory analyses are crucial to differentiate between the 2 diseases. Hyper-IL-6 syndromes are characterized by elevated serum levels of IgG, IgA, IgM, and C-reactive protein (CRP); thrombocytosis; anemia; hypoalbuminemia; hypocholesterolemia. In contrast, IgG4-RD does not share any of these characteristics. Therefore, the diagnosis of IgG4-RD requires not only pathological findings but also clinical and laboratory analyses.
AB - Lymphadenopathy is frequently observed in patients with immunoglobulin G4-related disease (IgG4-RD) and sometimes appears as the first manifestation of the disease. The diagnosis of IgG4-related lymphadenopathy is complicated owing to a great histological diversity, with at least 5 histological subtypes. Indeed, lymph node biopsy may be performed under the suspicion that the lymphadenopathy is a malignant lymphoma or other lymphoproliferative disorder. The diagnosis of IgG4-RD is characterized by both elevated serum IgG4 (135mg/dL) and histopathological features, including a dense lymphoplasmacytic infiltrate rich in IgG4 + plasma cells (IgG4 +/IgG + plasma cell ratio 40%). However, patients with hyper-interleukin (IL-) 6 syndromes such as multicentric Castlemans disease, rheumatoid arthritis, and other immune-mediated conditions frequently show lymph node involvement and often fulfill the diagnostic criteria for IgG4-RD. Owing to these factors, IgG4-RD cannot be differentiated from hyper-IL-6 syndromes on the basis of histological findings alone. Laboratory analyses are crucial to differentiate between the 2 diseases. Hyper-IL-6 syndromes are characterized by elevated serum levels of IgG, IgA, IgM, and C-reactive protein (CRP); thrombocytosis; anemia; hypoalbuminemia; hypocholesterolemia. In contrast, IgG4-RD does not share any of these characteristics. Therefore, the diagnosis of IgG4-RD requires not only pathological findings but also clinical and laboratory analyses.
UR - http://www.scopus.com/inward/record.url?scp=84863664842&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863664842&partnerID=8YFLogxK
U2 - 10.1155/2012/572539
DO - 10.1155/2012/572539
M3 - Article
VL - 2012
JO - International Journal of Rheumatology
JF - International Journal of Rheumatology
SN - 1687-9260
M1 - 572539
ER -