The autoimmune IgG4 -associated endocrine pathology

Yukina, Marina; Юрьевна, Юкина Марина; Troshina, Ekaterina A.; Анатольевна, Трошина Екатерина; Платонова, Н. М.; Михайловна, Платонова Надежда; Nuralieva, Nurana; Нурана, Ф Нуралиева

doi:10.14341/omet2017343-47

Cited by 4 publications

(4 citation statements)

References 30 publications

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“…выявили связь всех перечисленных выше заболеваний с повышенным уровнем продукции IgG4. IgG4-АЗ -это хроническая иммуноопосредованная патология различных органов, характеризующаяся муароподобным фиброзным воспалением пораженных тканей, их увеличением (отеком) и обильной инфильтрацией IgG4-положительными плазматическими клетками, а также повышением уровня сывороточного IgG4 [6].…”

Section: Igg4-азunclassified

“…Чаще встречается у молодых мужчин со значительно повышенным уровнем АТ ТГ и АТ ТПО. По данным ультразвукового исследования характерна пониженная эхогенность ткани щитовидной железы [6]. У пациентов с IgG4-опосредованным АИТ наблюдают более высокий риск развития гипотиреоза и значительное увеличение щитовидной железы, что часто служит показанием к тиреоидэктомии [5].…”

Section: патология щитовидной железы (тиреоидит риделя фиброзирующий аутоиммунный тиреоидит)unclassified

“…По структуре ритуксимаб относится к IgG1. Fab-фрагмент ритуксимаба связывается с CD20-АГ на лимфоцитах и при участии Fc-домена инициирует иммунологические реакции, опосредующие лизис В-клеток [6]. Cнижение уровня IgG4 на фоне несущественных изменений других подклассов IgG при терапии ритуксимабом может объясняться тем, что клетки IgG4+ более короткоживущие, чем клетки, экспрессирующие другие подклассы IgG [35].…”

Section: терапия Igg4-аз сегодня и в перспективеunclassified

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IGG4-related diseases in endocrinology

Rumyantsev¹,

Kozlov²,

Kolpakova³

et al. 2020

Probl Endokrinol (Mosk)

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Immunoglobulin-G4-related disease (IgG4-RD) is a chronic immunomediated pathology of different organs of local or systemic nature, which has been established as a separate clinical entity in the early 2000s and is characterized by storiform fibroid inflammation of the affected tissues, their increase, and elevated serum immunoglobulin-G4 (IgG4) levels. The most common manifestations of the disease are major salivary and lacrimal gland enlargement, lymphadenopathy and type 1 autoimmune pancreatitis (AIP1), however, other organs may be also involved (the thyroid, eyes, meninges, heart, lungs, kidneys, aorta, upper airways, mesentery, etc.). The effectiveness of treatment of IgG4-RD, as well as other pathological conditions, is also determined by the timely diagnosis. However, the latter is complicated due to the variety of clinical manifestations and rather variable diagnostic criteria. It is necessary to constantly update the evidence-based knowledge and diagnostic algorithms within this pathology in order to overcome the difficulties, and involve immunologists, endocrinologists, pathologists and specialists in other spheres. This review provides information about the etiology, pathogenesis, and current methods of diagnosis and treatment of IgG4-related diseases, as well as examples of some manifestations of IgG4-RD that an endocrinologist may face in practice.

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Section: Igg4-азunclassified

Section: патология щитовидной железы (тиреоидит риделя фиброзирующий аутоиммунный тиреоидит)unclassified

Section: терапия Igg4-аз сегодня и в перспективеunclassified

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IGG4-related diseases in endocrinology

Rumyantsev¹,

Kozlov²,

Kolpakova³

et al. 2020

Probl Endokrinol (Mosk)

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“…В то же время при CTLA-4-индуцированном гипофизите несахарный диабет встречается крайне редко [8]. Также следует исключить другие причины гипофизита, например инфильтрацию IgG4-плазмоцитами (IgG4-ассоциированный гипофизит), саркоидоз [34,35].…”

Section: поражение гипофизаunclassified

Lesions in endocrine glands as a complication of immunotherapy in the practice of oncologist

et al. 2019

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This review describes the lesions of the endocrine system that occur as a result of immunotherapy of cancer. This phenomenon is associated with the inhibition by monoclonal antibodies of checkpoints, which do not allow the immune system to affect tumor cells: CTLA-4, PD-1 and PD-L1. Immunotherapy by this group of drugs allows to increase the life expectancy of patients with cancer, but it also leads to the development of autoimmune endocrinopathies (thyroiditis, adrenalitis, diabetes mellitus, hypophysitis), which often manifest by life-threatening conditions. In view of the above, the necessity to carry out regular monitoring of the function of target organs in patients receiving immunotherapy for malignant tumors is discussed. On the other hand, the phenomenon of developing the autoimmune endocrinopathies during therapy with immunological checkpoints inhibitors is of fundamental interest to endocrinologists. Iatrogenic lesions of the endocrine system are unique models of initiation of immune autoagression. Thus, the development of adrenalitis in patients receiving treatment with a PD-1 inhibitor suggests that the PD-1 is involved in the pathogenesis of autoimmune adrenal insufficiency in patients not receiving treatment with this drug. Thus, clarification of the role of PD-1 in the development of adrenalitis is required. The results of such investigations will allow to identify the risk groups for the development of autoimmune adrenal insufficiency and, accordingly, timely diagnosing it and beginning treatment.

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Features of the course of diabetes mellitus in IgG4-associated disease

Panevin,

Torgashina,

Movsesyan

2023

Diabetes mellitus

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IgG4-related disease (IgG4-RD) is characterized by the appearance of tumor-like foci in one or more organs, occurring synchronously or metachronously, due to fibro-inflammatory changes with hypersecretion of immunoglobulin G subclass 4 (IgG4) in tissues and/or blood serum. Diabetes mellitus (DM) develops among 43-68% of patients with IgG4-related pancreatitis. Diabetes against the background of IgG4-RD can be caused both by damage to the endocrine part of the pancreas and the use of glucocorticosteroids, but its course is moderate, with a rare need for insulin therapy. In both cases, the use of genetically engineered biological therapy with rituximab may be accompanied by an improvement in carbohydrate metabolism. This article describes the course of diabetes and the need for hypoglycemic therapy for 1.5 years in a patient treated with IgG4-RD.

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The autoimmune IgG4 -associated endocrine pathology

Cited by 4 publications

References 30 publications

IGG4-related diseases in endocrinology

IGG4-related diseases in endocrinology

Lesions in endocrine glands as a complication of immunotherapy in the practice of oncologist

Features of the course of diabetes mellitus in IgG4-associated disease

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