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題名 | 頭頸部IgG4關聯疾病=Immunoglobulin G4-related Disease of Head and Neck |
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作者 | 王鐙慶; 蔡明村; Wang, Teng-chin; Tsai, Ming-tsun; |
期刊 | 臺灣耳鼻喉頭頸外科雜誌 |
出版日期 | 20160700、20160800、20160900 |
卷期 | 51:3 2016.07-09[民105.07-09] |
頁次 | 頁199-203 |
分類號 | 415.695 |
語文 | chi |
關鍵詞 | 自體免疫性疾病; IgG4關聯疾病; 唾液腺腫大; 淋巴腺腫大; Autoimmune disease; IgG4 related disease; Salivary gland swelling; Lymphadenopathy; |
中文摘要 | IgG4關聯疾病(IgG4-related disease)是近十幾年來才被認識的新疾病。此病可以影響體內單一或多重器官,造成受累器官纖維化及慢性發炎並形成組織腫脹。診斷主要依據血清IgG4濃度升高以及特有的組織病理特徵。治療首選為高劑量皮質類固醇(glucocorticoids)作為第一線藥物,在某些無症狀的病患僅須觀察追蹤即可。本文報告1名57歲病患主訴雙側腮腺,下頜腺和頦下區淋巴無痛性腫大3年,曾在他院接受腮腺及淋巴細針抽吸檢查但無確切診斷,因腫塊情況無明顯改善故至本院就診接受檢查。由於病患的血清免疫球蛋白IgG及IgG4均明顯上升,懷疑是自體免疫疾病故接受較淺層的頦下淋巴切片檢查。病理組織檢查證實是IgG4關聯疾病。因無犯及其他器官故接受保守追蹤。 |
英文摘要 | Immunoglobulin G4 (IgG4)-related disease has emerged as a newly recognized disease over the past 10 years. It is a systemic disease involving multiple organs and can cause fibrosis, chronic inflammation, and tissue swelling. Diagnosis depends on the elevation of serum IgG4 concentration and specific histopathological features. High-dose corticosteroids are the first-line therapy for symptomatic relief, whereas conservative policies (close follow-up) are sufficient for asymptomatic patients. We report a 57-year-old man who complained of painless swelling of the bilateral parotid glands, submandibular glands, and submental lymph nodes for 3 years. Diagnosis remained unclear after fine-needle aspiration targeting the parotid glands and lymph nodes at another institute. The patient visited our institute for additional opinions. Seroimmunology examination revealed elevated serum IgG and IgG4, and systemic immune disease was suspected. An additional submental lymph node biopsy was performed, the results of which confirmed IgG4-associated disease. Abdominal sonography and chest plain film did not reveal any abnormalities. Because this patient did not present constitutional symptoms, close observation was suggested without additional medication. |
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