IgG4-positive Hashimoto thyroiditis and its association with IgG4-related sclerosing disease

Khatiwada, Aagat Sharma; Choudhury, Natasha

doi:10.1136/bcr-2022-249181

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…It is imperative to obtain enough tissue following thyroidectomy or open/core/surgical biopsy in order to analyze the IgG4 status. In addition to this assessment, meticulous histological description, clinical presentation (thyroid enlargement and woody consistency), and other fibrotic or sclerotic potential involvement at non-thyroid organs help the distinction among the four types of IgG4-RTD [ 72 , 73 ]. Some authors use the term “IgG4-related thyroiditis” mostly referring to IgG4-related Hashimoto’s thyroiditis (not RT).…”

Section: Discussionmentioning

confidence: 99%

“…The clear distinction between these two entities is yet a matter of debate. Stony consistency seems to be the clinically distinctive feature of the fibrotic variant of Hashimoto’s thyroiditis [ 72 , 73 ]. Adams et al [ 74 ] released some recommendations for reporting this subtype of IgG4-RTD: lack of extra-thyroid IgG4-RD, lack of disease spreading to thyroid surrounding tissues (which seems the usual signature of RT), stromal fibrosis (at least 30%) at the histological report, IgG4/IgG4 ratio of more than 30% while the required percent of IgG4-carrying plasma cells (per HPF) depends on stromal fibrosis distribution (>20/HPF for >50%, respective >30/HPF for 30–50%), and other pathological findings such as fibrosis at inter-follicular level and follicles destruction without phlebitis [ 74 ].…”

Section: Discussionmentioning

confidence: 99%

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Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)

Cârșote

Nistor

2023

Biomedicines

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Recently, Riedel’s thyroiditis (RT) was assimilated into the larger spectrum of immunoglobulin IgG4-related disease (IgG4-RD) in addition to a particular frame of IgG4-related thyroid disease (IgG4-RTD), underlying IgG4-RT, IgG4-associated Hashimoto’s thyroiditis (and its fibrotic variant), and IgG4-related Graves’s disease. Our objective was to overview recent data on RT, particularly IgG4-RD and IgG4-RTD. The case and study– sample analysis (2019–2023) included 293 articles and selected 18 original studies: nine single case reports (N = 9, female/male = 2/1, aged: 34–79 years, 5/9 patients with serum IgG4 available data, 2/5 with high serum IgG4) and four case series (N = 21; 4/5 series provided data on IgG4 profile, 3/21 had serum IgG4 assays, and 2/3 had abnormally high values). IgG4-RD and thyroid findings were analyzed in three cohorts (N = 25). Another two studies (N = 11) specifically addressed IgG4-RTD components. On presentation, the patients may have hypothyroidism, transitory thyrotoxicosis, goiter, long-term history of positive anti-thyroid antibodies, and hypoechoic ultrasound thyroid pattern. The 5-year analysis (N = 66) showed the rate of serum IgG4 evaluation remained low; normal values do not exclude RT. Mandatory histological and immunohistochemistry reports point out a high content of IgG4-carrying plasma cells and IgG4/IgG ratio. Unless clinically evident, histological confirmation provides a prompt indication of starting corticoid therapy since this is the first-line option. Surgery, if feasible, is selective (non-responders to medical therapy, emergency tracheal intervention, and open/core needle biopsy). Current open issues are identifying the role of serum IgG4 assays in patients with IgG4-RD, finding out if all cases of RT are IgG4-mediated, applying IgG4-RTD criteria of differentiation among four entities, and providing an RT/IgG4-RTD guideline from diagnosis to therapy. It remains that the central aim of approaching RT in daily practice is the early index of suspicion in order to select patients referred for further procedures that provide enough histological/immunohistochemistry material to confirm RT and its high IgG4 burden.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)

Cârșote

Nistor

2023

Biomedicines

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Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy

Zhao,

Ge,

et al. 2023

Open Life Sciences

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To evaluate the clinical significance of detecting serum IgG4 and the IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy (TAO) and to explore whether high serum IgG4 levels and the IgG4/IgG ratio are associated with the severity and activity of TAO, we retrospectively assessed the records of 78 TAO patients and 32 controls collected in our hospital from July 2020 to July 2022. The TAO patients were divided into TAO inactive and TAO active phase groups according to the clinical activity score (CAS), and we evaluated the association between the serum IgG4 levels, the IgG4/IgG ratio, and the clinical data of the participants. The levels of IgG4 significantly increased in the TAO active group compared to those in the inactive and control groups (P < 0.05). Additionally, the number of patients with increased IgG4 levels (≥135 mg/dL) in the TAO active group was markedly higher than that in the inactive and control groups (P < 0.05). The IgG4/IgG ratio was also significantly enhanced in the TAO active group compared to the inactive and control groups (P < 0.05). CAS was identified as an independent factor influencing IgG4 levels in patients with TAO. The levels of serum IgG4, as well as the IgG4/IgG ratio, were significantly increased in some patients with active TAO, and they were related to the CAS, suggesting that the pathogenesis of TAO may be heterogeneous.

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Hashimoto Tiroidit’i ile Papiller Tiroid Karsinom Birlikteliği ve Prognoza Etkileri

CEYRAN

2023

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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ÖZET Tiroidit, tiroid glandının inflamasyonu ile karakterize, çeşitli hastalıkları içeren genel bir terimdir. Hashimoto tiroiditi, en sık otoimmun tiroid hastalığıdır ve son yıllarda insidansı giderek artmaktadır. Papiller tiroid kanseri ise en sık tiroid kanseri olup Hashimo tiroiditi zemininde genel popülasyona göre daha sık görülmektedir. Hashimoto tiroiditi ile papiller tiroid karsinomu arasındaki ilişki ilk olarak 1955 yılında Dailey ve ark tarafından ortaya atıldığından beri bununla ilgili tartışmalar ve araştırmalar hala devam etmektedir. Hashimoto tiroiditi ve papiller tiroid karsinomu birlikte görülme insidansı literatüre göre % 0,5 ile % 41,4 arasında değişmekte olup ortalama yaş daha düşük bulunmuştur. Hashimoto tiroiditi ve papiller tiroid karsinom birlikteliğinin koruyucu bir etki gösterdiği, Hashimoto tiroiditi ile birlikte olan papiller tiroid karsinomunun daha az agresiv, tümörün daha küçük ve daha sıklıkla multifokal olduğu, daha az lenf nod invazyonu gösterdiği bildirilmiştir. Hashimoto tiroiditi zemininde, multifokal alanlarda izlenen, displastik tirosit gruplarındaki papiller tiroid karsinomu ilişkili gen aktivasyonları, Hashimoto tiroiditi- .papiller tiroid karsinom birlikteliği ve multifokaliteden sorumlu tutulabilir. Anahtar kelimeler: Hashimoto tiroidit’i, Papiller tiroid karsinomu, Prognoz, Tiroidit.

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IgG4-positive Hashimoto thyroiditis and its association with IgG4-related sclerosing disease

Cited by 3 publications

References 22 publications

Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)

Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)

Clinical significance of the detection of serum IgG4 and IgG4/IgG ratio in patients with thyroid-associated ophthalmopathy

Hashimoto Tiroidit’i ile Papiller Tiroid Karsinom Birlikteliği ve Prognoza Etkileri

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