Elevated Serum Immunoglobulin G4 Levels in Patients with Graves' Disease and Their Clinical Implications

Takeshima, Ken; Inaba, Hidefumi; Furukawa, Yasushi; Nishi, Masahiro; Yamaoka, Hiroyuki; Miyamoto, Waka; Ota, Takayuki; Doi, Asako; Kawashima, Hiromichi; Ariyasu, Hiroyuki; Wakasaki, Hisao; Furuta, Hiroto; Nakao, Taisei; Sasaki, Hideyuki; Akamizu, Takashi

doi:10.1089/thy.2013.0448

Cited by 48 publications

(59 citation statements)

References 26 publications

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“…Thus, patient background differed between the studies. An association between IgG4 thyroiditis and male predominance or diffuse hypoechogenicity has also been suggested in other reports [7,14]. Consistent with those studies, ultrasonography revealed that hypoechoic areas were larger in the elevated IgG4 group than in the non-elevated IgG4 group in our prospective study.…”

Section: Discussionsupporting

confidence: 92%

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Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

et al. 2015

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Section: Discussionsupporting

confidence: 92%

“…In accordance with the diagnostic criteria for IgG4-RD, patients 4 and 5 probably had extra-thyroid at the maximum position [7,13].…”

Section: Clinical Features Of Six Patients With Elevated Serum Igg4 Lmentioning

confidence: 54%

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Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

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“…It is believed to occur equally among males and females [1,2]. Recent reports have also suggested that a small fraction of Graves' disease patients also have elevated IgG4 levels with some features suggestive of IgG4TD [21,22]. Takeshima K et al reported that 6.4% of 109 patients with Graves' disease had elevated IgG4 titres [21].…”

Section: Igg4 Related Thyroid Disease (Igg4rtd)mentioning

confidence: 99%

Zaburzenia tarczycy związane z immunoglobuliną G4 — wyzwanie diagnostyczne i wyniki kliniczne

Dutta

Ahuja

Selvan

2016

Endokrynologia Polska

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Ig-G4 related disease (IgG4RD) is a heterogeneous disorder with multi-organ involvement recognised as a separate entity at the start of this century only. It is currently one of the hottest areas of clinical and translational research across specialties. Thyroid involvement in IgG4RD is rare, believed to occur in less than 4% of cases, may be isolated or may be associated with other organ involvement. As of today Riedel's thyroiditis, fibrosing variant of Hashimoto's thyroiditis, and few patients of Graves' orbitopathy represent the types of IgG4-related thyroid disease (IgG4RTD). This disorder is frequently confused with malignancy due to the intense sclerosis of thyroid resulting in hard texture on palpation compounded by often-associated compressive symptoms. Diagnosis involves establishing high circulating levels of IgG4 > 135 mg/dL, increased serum IgG4 to IgG ratio of > 8%, immunohistochemistry showing dense lymphoplasmacellular inflammatory infiltrate consisting of IgG4-positive plasma cells with storiform fibrosis and obliterative phlebitis, and increased IgG4 positive plasma cell > 10 cells per high-power field when at least three fields are evaluated. Glucocorticoids are the primary form of therapy in IgG4RD. However, their role in IgG4RTD needs to be evaluated. As of today levothyroxine supplementation for resulting hypothyroidism, appropriate management of Graves' disease, and surgical excision of thyroid in case of compressive symptoms remain the primary treatment options. StreszczenieChoroba związana z Ig-G4 (IgG4RD) jest heterogennym zaburzeniem z zajęciem wielu narządów. Jako osobna jednostka chorobowa została wyodrębniona dopiero na początku tego stulecia. Choroba ta stanowi aktualnie najgorętszy obszar badań klinicznych i translacyjnych w różnych dziedzinach medycyny. Zajęcie tarczycy w IgG4RD jest rzadkie, szacuje się, że występuje w około 4% przypadków, może być izolowane lub związane zajęciem innych narządów. Na chwilę obecną zapalenie tarczycy związane z IgG4 (IgG4RTD) reprezentują: zapalenie tarczycy Riedela, które jest włókniejącą odmianą zapalenia tarczycy w chorobie Hashimoto oraz niektórzy pacjenci z orbitopatią Gravesa. Zapalenie tarczycy związane z IgG4 jest często mylone z chorobą nowotworową ze względu na nasilone stwardnienie tarczycy, które powoduje powstanie twardej struktury wyczuwalnej w badaniu palpacyjnym z towarzyszącymi często objawami uciskowymi. Rozpoznanie choroby obejmuje: stwierdzenie wysokich stężeń krążącej IgG4 > 135 mg/dl, zwiększony stosunek w surowicy IgG4 do IgG > 8%, w badaniu immunohistochemicznym stwierdzenie gęstych nacieków zapalnych złożonych z limfocytów i IgG4 dodatnich plazmocytów , z włóknieniem i zarostowym zapaleniem żył oraz zwiększeniem liczby IgG4 dodatnich plazmocytów > 10 w polu widzenia, jeżeli oceniono minimum 3 pola. Glikokortykosteroidy stanowią leczenie pierwszego wyboru w IgG4RTD. Niemniej ich rola w IgG4RTD wymaga dalszej oceny. Na chwilę obecną podstawowe opcje terapeutyczne obejmują: suplementację lewotyroksyny we wtórnej nied...

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“…An association between thyroid diseases such as Graves' disease, Hashimioto's thyroiditis, and RT and IgG4-related disease (IgG4-RD) has recently been reported [11][12][13][14][15]. Patients with IgG4-RD exhibit elevated serum IgG4 levels, IgG4-positive plasma cells, and tissue fibrosis and organ dysfunction caused by lymphocyte infiltration into multiple organs [16,17].…”

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confidence: 99%

Clinicopathological features of Riedel’s thyroiditis associated with IgG4-related disease in Japan

et al. 2015

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Elevated Serum Immunoglobulin G4 Levels in Patients with Graves' Disease and Their Clinical Implications

Cited by 48 publications

References 26 publications

Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

Zaburzenia tarczycy związane z immunoglobuliną G4 — wyzwanie diagnostyczne i wyniki kliniczne

Clinicopathological features of Riedel’s thyroiditis associated with IgG4-related disease in Japan

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Elevated Serum Immunoglobulin G4 Levels in Patients with Graves' Disease and Their Clinical Implications

Cited by 48 publications

References 26 publications

Distribution of serum immunoglobulin G4 levels in Hashimoto&rsquo;s thyroiditis and clinical features of Hashimoto&rsquo;s thyroiditis with elevated serum immunoglobulin G4 levels

Distribution of serum immunoglobulin G4 levels in Hashimoto&rsquo;s thyroiditis and clinical features of Hashimoto&rsquo;s thyroiditis with elevated serum immunoglobulin G4 levels

Zaburzenia tarczycy związane z immunoglobuliną G4 — wyzwanie diagnostyczne i wyniki kliniczne

Clinicopathological features of Riedel&rsquo;s thyroiditis associated with IgG4-related disease in Japan

Contact Info

Product

Resources

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Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

Distribution of serum immunoglobulin G4 levels in Hashimoto’s thyroiditis and clinical features of Hashimoto’s thyroiditis with elevated serum immunoglobulin G4 levels

Clinicopathological features of Riedel’s thyroiditis associated with IgG4-related disease in Japan