eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
State of the art paper

IgG4-related disease in endocrine practice

Agata Rzepecka, Anna Babińska, Krzysztof Sworczak

Arch Med Sci
Online publish date: 2017/10/20
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
IgG4-related disease is a set of symptoms resulting from a chronic, usually multiple organ inflammatory condition which affects various organs. It consists of lymphoplasmacytic infiltrations with attendant fibrosis and deep vein thrombosis. Frequently observed tissue lesions are accompanied by elevated IgG4 levels in serum. The etiopathogenesis of the lesions is of multifactor character and the clinical manifestation of the disease is highly diverse. The diagnostic process is based on the patient’s medical history, clinical examination and additional tests, including a histopathological examination of the infected organ’s tissues. Almost forty different locations of the disease have been reported, including disorders of the endocrine system. IgG4-related endocrinopathies are quite rare. However, it is likely that the diagnosis is under-reported due to lack of awareness of this clinical entity. Despite increasing interest in the subject, there are not enough reliable studies evaluating the link between IgG4-RD and endocrine disorders.

IgG4-related disease, Hashimoto’s thyroiditis, Riedel’s thyroiditis, hypophysitis, Graves’ ophthalmopathy

Stone JH, Khosroshahi A, Deshpande V, et al. Recommendation for the Nomenclature of IgG4-Related disease and its individual organ system manifestation. Arthritis Rheum 2012; 64: 3061-7.
Brito-Zerón P, Ramos-Casals M, Bosch X, Stone JH. The clinical spectrum of IgG4-related disease. Autoimmun Rev 2014; 13: 1203-10.
Brito-Zerón P, Bosch X, Ramos-Casals M, Stone JH. IgG4-related disease: advances in the diagnosis and treatment. Best Pract Res Clin Rheumatol 2016; 30: 261-78.
Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease Mod Rheumatol 2012; 22: 21-30.
Kamisawa T, Funata N, Hayashi Y, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol 2003; 38: 982-4.
Wallace ZS, Deshpande V, Mattoo H, et al. IgG4-related disease: baseline clinical and laboratory features in 125 patients with biopsy-proven disease. Arthritis Rheumatol 2015; 67: 2466-75.
Katsura M, Mori H, Kunimatsu A, et al. Radiological features of IgG4-RD in the head, neck and brain. Neuroradiology 2012; 54: 873-82.
Chen H, Lin W, Wang Q, et al. IgG4-related disease in Chinese cohort: prospective study. Scand J Rheumatol 2014; 43: 70-4.
Batu ED, Arici ZS, Orhan D, Kiratli H, Özen S. Immunoglobulin G4-related orbital disease: pediatric case. Clin Exp Rheumatol 2015; 33: 409-10.
Corujeira S, Ferraz C, Nunes T, Fonseca E, Vaz LG. Severe IgG4-related disease in young child: a diagnosis challenge. Case Rep Pediatr 2015; 2015: 140753.
Aalberse RC, Schuurman J. IgG4 breaking the rules. Immunology 2002; 105: 9-19.
Aalberse RC, Stapel SO, Schuurman J, Rispens T. Immunoglobulin G4: an odd antibody. Clin Exp Allergy 2009; 39: 469-77.
Culver EL, Vermeulen E, Makuch M, et al. Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease. Ann Rheum Dis 2015; 74: 944-7.
Vijay HM, Perelmutter L. Inhibition of reagin-mediated PCA reactions in monkeys and histamine release from human leukocytes by human IgG4 subclass. Int Arch Allergy Appl Immunol 1977; 53: 78-87.
Gwynn CM, Ingram J, Almousawi T, Stanworth DR. Bronchial provocation tests in atopic patients with allergen specific IgG4 antibodies. Lancet 1982; 1: 254-6.
van der Giessen M, Homan WL, van Kernbeek G, Aalberse RC, Dieges PH. Subclass typing of IgG antibodies formed by grass pollen allergic patients during immunotherapy. Int Arch Allergy Appl Immunol 1976; 50: 625-40.
Okazaki K, Uchida K, Ohana M, et al. Autoimmune-related pancreatitis is associated with autoantibodies and a Th1/Th2-type cellular immune response. Gastroenterology 2000; 118: 573-81.
Frulloni L, Lunardi C, Simone R, et al. Identification of a novel antibody associated with autoimmune pancreatitis. N Engl J Med 2009; 361: 2135-42.
Du H, Shi L, Chen P, et al. Prohibitin is involved in patients with IgG4 related disease. PLoS One 2015; 10: e0125331
Guarneri F, Guarneri C, Benvenga S. Helicobacter pylori and autoimmune pancreatitis: role of carbonic anhydrase via molecular mimicry? J Cell Mol Med 2005; 9: 741-4.
Zen Y, Nakanuma Y. Patogenesis of IgG4-related disease. Curr Opin Rheumatol 2011; 23: 114-8.
Della Torre E, Mattoo H, Mahajan VS, Carruthers M, Pillai S, Stone JH. Prevalence of atopy, eosinophilia, and IgE elevation in IgG4-related disease. Allergy 2014; 69: 269-72.
Furukawa S, Moriyama M, Tanaka A, et al. Preferential M2 macrophages contribute to fibrosis in IgG4-related dacryoadenitis and sialoadenitis, so-called Mikulicz’s disease. Clin Immunol 2015; 156: 9-18.
Wallace ZS, Mattoo H, Carruthers M, et al. Plasmablasts as a biomarker for IgG4-related disease, independent of serum IgG4 concentrations. Ann Rheum Dis 2015; 74: 190-5.
Umehara H, Nakajima A, Nakamura T, et al. IgG4-related disease and its pathogenesis – cross-talk between innate and acquired immunity. Int Immunol 2014; 26: 585-95.
Stone JH, Brito-Zerón P, Bosch X, Ramos-Casals M. Diagnostic approach to the complexity of IgG4-related disease. Mayo Clin Prac 2015; 90: 927-39.
Khosroshahi A, Wallace ZS, Crowe JL, et al.; Second International Symposium on IgG4-Related Disease. International Consensus Guidance Statement on the management and treatment of IgG4-related disease. Arthritis Rheumatol 2015; 67: 1688-99.
Deshpande V, Zen Y, Chan JK, et al. Consensus statement on the pathology of IgG4-related disease. Mod Pathol 2012; 25: 1181-92.
Yamamoto M, Yajima H, Takahashi H, et al. Everyday clinical practice in IgG4-related dacryoadenitis and/or sialadenitis: results from the SMART database. Mod Rheumatol 2015; 25: 199-204.
Kazuhiro K, Hajime Y, Tsugumitsu K, et al. Screening for IgG4-type anti-nuclear antibodies in IgG4-related disease. BMC Musculoskelet Disord 2015; 16: 129.
Lauwyck J, Piette Y, Van Walleghem L, De Geeter F. IgG4-related disease: the utility of (18)F-FDG PET/CT in diagnosis and treatment. Hell J Nucl Med 2015; 18 Suppl 1: 155-9.
Yamamoto M, Takahashi H, Tabeya T, et al. Risk of malignancies in IgG4-related disease. Mod Rheumatol 2012; 22: 414-8.
Hirano K, Tada M, Sasahira N, et al. Incidence of malignancies in patients with IgG4-related disease. Intern Med 2014; 53: 171-6.
Hao SP, Chen JF, Yen KC. Riedel’s thyroiditis associated with follicular carcinoma. Eur Arch Otorhinolaryngol 1999; 256: 470-2.
Watanabe T, Maruyama M, Ito T, et al. Clinical features of a new disease concept, IgG4-related thyroiditis. Scand Rheumatol 2013; 42: 325-30.
Kottahachchi D, Topliss DJ. Immunoglobulin G4-related thyroid diseases. Eur Thyroid J 2016; 5: 231-9.
Wang CJ, Wu TJ, Lee CT, Huang SM. A misdiagnosed Riedel’s thyroiditis successfully treated by thyroidectomy and tamoxifen. J Formos Med Assoc 2012; 111: 719-23.
Zgliczyński W. Wielka interna: endokrynologia. Medical Tribune Polska, Warsaw 2011; 291-2.
Schwaegerle SM, Bauer TW, Esselstyn CB. Riedel’s thyroiditis. Am J Clin Pathol 1988; 90: 715-22.
Dahlgren M, Khosroshahi A, Nielsen GP, Deshpande V, Stone JH. Riedel’s thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum. Arthritis Care Res (Hoboken) 2010; 62: 1312-8.
Fatourechi MM, Hay ID, McIver B, Sebo TJ, Fatourechi V. Invasive fibrous thyroiditis (Riedel thyroiditis): the Mayo Clinic experience, 1976-2008. Thyroid 2011; 21: 765-72.
Kottahachchi D, Topliss DJ. Immunoglobulin G4-related thyroid diseases. Eur Thyroid J 2016; 5: 231-9.
Levy JM, Hasney CP, Friedlander PL, Kandil E, Occhipinti EA, Kahn MJ. Combined mycophenolate mofetil and prednisone therapy in tamoxifen- and prednisone-resistant Riedel’s thyroiditis. Thyroid 2010; 20: 105-7.
Carruthers MN, Topazian MD, Khosroshahi A, et al. Rituximab for IgG4-related disease: a prospective, open-label trial. Ann Rheum Dis 2015; 74: 1171-7.
Hiromatsu Y, Satoh H, Amino N. Hashimoto’s thyroiditis: history and future outlook. Hormones (Athens) 2013; 12: 12-8.
Zhang J, Zhao L, Gao Y, et al. A classification of Hashimoto’s thyroiditis based on immunohistochemistry for IgG4 and IgG. Thyroid 2014; 24: 364-70.
Li Y, Bai Y, Liu Z, et al. Immunohistochemistry of IgG4 can help subclassify Hashimoto’s autoimmune thyroiditis. Pathol Int 2009; 59: 636-41.
Deshpande V, Huck A, Ooi E, Stone JH, Faquin WC, Nielsen GP. Fibrosing variant of Hashimoto thyroiditis is an IgG4 related disease. J Clin Pathol 2012; 65: 725-8.
Li Y, Nishihara E, Hirokawa M, Taniguchi E, Miyauchi A, Kakudo K. Distinct clinical, serological, and sonographic characteristics of Hashimoto’s thyroiditis based with and without IgG4-positive plasma cells. J Clin Endocrinol Metab 2010; 95: 1309-17.
Katz SM, Vickery AL Jr. The fibrous variant of Hashimoto’s thyroiditis. Hum Pathol 1974; 5: 161-70.
Dutta D, Ahuja A, Selvan C. Immunoglobulin G4 related thyroid disorders: diagnostic challenges and clinical outcomes. Endokrynol Pol 2016; 67: 520-4.
Hennessey JV. Clinical review: Riedel’s thyroiditis: a clinical review. J Clin Endocrinol Metab 2011; 96: 3031-41.
Popławska-Kita A, Kościuszko-Zdrodowska M, Siewko K, et al. High serum IgG4 concentrations in patients with Hashimoto’s thyroiditis. Int J Endocrinol 2015; 2015: 706843.
Takeshima K, Ariyasu H, Inaba H, et al. Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels. Endocin J 2015; 62: 711-7.
Bozkirli E, Bakiner OS, Ersozlu Bozkirli ED, et al. Serum immunoglobulin G4 levels are elevated in patients with Graves’ ophthalmopathy. Clin Endocrinol (Oxf) 2015; 83: 962-7.
Howlett TA, Levy MJ, Robertson IJ. How reliably can autoimmune hypophysitis be diagnosed without pituitary biopsy. Clin Endocrinol (Oxf) 2010; 73: 18-21.
van der Vliet HJ, Perenboom RM. Multiple pseudotumors in IgG4-associated multifocal systemic fibrosis. Ann Intern Med 2004; 141: 896-7.
Shikuma J, Kan K, Ito R, et al. Critical review of IgG4-related hypophysitis. Pituitary 2017; 20: 282-91.
Shimatsu A, Oki Y, Fujisawa I, Sano T. Pituitary and stalk lesions (infundibulo-hypophysitis) associated with immunoglobulin G4-related systemic disease: an emerging clinical entity. Endocr J 2009; 56: 1033-41.
Leporati P, Landek-Salgado MA, Lupi I, Chiovato L, Caturegli P. IgG4-related hypophysitis: a new addition to the hypophysitis spectrum. J Clin Endocrinol Metab 2011; 96: 1971-80.
Nishioka H, Shibyya M, Haraoka J. Immunohistochemical study for IgG4-positive plasmacytes in pituitary inflammatory lesions. Endocr Pathol 2010; 21: 236-41.
Nqaosuwan K, Trongwongsa T, Shuangshotu S. Clinical course of IgG4-related hypophysitis presenting with focal seizure and relapsing lymphocytic hypophysitis. BMC Endocr Disord 2015; 15: 64.
Harano Y, Honda K, Akiyama Y, Kotajima L, Arioka H. A case of IgG4-related hypophysitis presented with hypopituitarism and diabetes insipidus. Clin Med Insights Case Rep 2015; 8: 23-6.
Hori M, Makita N, Andoh T, et al. Long-term clinical course of IgG4-related systemic disease accompanied by hypophysitis. Endocr J 2010; 57: 485-92.
Chorti A, Papavtamidis TS, Michalopoulos A. Calcifying fibrous tumor review of 157 patients reported in international literature. Medicine (Baltimore) 2016; 95: e3690.
Wu T, Zhu P, Duan X, Yang X, Lu D. Calcifying fibrous pseudotumor of the adrenal gland: a rare case report. Mol Clin Oncol 2016; 5: 252-4.
Bartalena L, Chiovato L. Graves’-like orbitopathy: do not forget IgG4-related disease. J Endocrinol Invest 2014; 37: 1233-5.
Fonte R, Pirali B, Caramia V, et al. Graves’-like orbitopathy in a patient with chronic autoimmune pancreatitis. Thyroid 2011; 21: 1389-92.
Tiegs-Heiden CA, Eckel LJ, Hunt CH, et al. Immunoglobulin G4-related disease of the orbit: imaging features in 27 patients. AJNR Am J Neuroradiol 2014; 35: 1393-7.
Moritani KT. Orbital IgG4-related disease: clinical features and diagnosis. ISRN Rheumatol 2012; 2012: 412896.
Ebbo M, Patient M, Grados A, et al. Ophthalmic manifestations in IgG4-related disease Clinical presentation and response to treatment in a French case-series. Medicine (Baltimore) 2017; 96: e6205.
Kubota T, Moritani S, Katayama M, Tarasaki H. Ocular adnexal IgG4-related lymphoplasmacytic infiltrative disorder. Arch Ophthalmol 2010; 128: 577-84.
Plaza JA, Garrity JA, Dogan A, Ananthamurthy A, Witzig TE, Salomão DR. Orbital inflammation with IgG4-positive plasma cells: manifestation of IgG4 systemic disease. Arch Ophthalmol 2011; 129: 421-8.
Sato Y, Ohshima K, Ichimura K, et al. Ocular adnexal IgG4-related disease has uniform clinicopathology. Pathol Int 2008; 58: 465-70.
Wallace ZS, Deshpande V, Stone JH. Ophthalmic manifestations of IgG4-related disease: single-center experience and literature review. Semin Arthritis Rheum 2014; 43: 806-17.
Kanno A, Masamune A, Okazaki K, et al.; Research Committee of Intractable Diseases of the Pancreas. Nationwide epidemiological survey of autoimmune pancreatitis in Japan in 2011. Pancreas 2015; 44: 535-9.
Okazaki K, Kawa S, Kamisawa T, et al.; Working Committee of the Japan Pancreas Society and the Research Committee for Intractable Pancreatic Disease supported by the Ministry of Health, Labour and Welfare of Japan. Amendment ofthe Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 I. Concept and diagnosis of autoimmune pancreatitis. J Gastroenterol 2014; 49: 567-88.
Miyamoto Y, Kamisawa T, Tabata T, et al. Short and long-term outcomes of diabetes mellitus in patients with autoimmune pancreatitis after steroid therapy. Gut Liver 2012; 6: 501-4.
Yamada T, Hiraoka E, Miyazaki T, Sato J, Ban N. Diabetes as first manifestation of autoimmune pancreatitis. Am J Med Sci 2017; 353: 498-9.
Masuda A, Shimomi H, Matsuda T, et al. The relationship between pancreatic atrophy after steroid therapy and diabetes mellitus in patients with autoimmune pancreatitis. Pancreatology 2014; 14: 361-5.
Ito T, Nakamura T, Fujumori N, et al. Characteristic of pancreatic diabetes in patiens with autoimmune pancreatitis. J Dig Dis 2011; 12: 210-6.
Inoue D, Yoshida K, Yoneda N, et al. IgG4-related disease: data of 235 consecutive patients. Medicine (Baltimore) 2015; 94: e680.
Ebbo M, Daniel L, Pavic M, et al. IgG4-related systemic disease: features and treatment response in a French cohort: results of a multicenter registry. Medicine (Baltimore) 2012; 91: 49-56.
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe